Gastric Cancer Staging

Staging Gastric Cancer 

A variety of diagnostic or imaging tests may be used to diagnose and evaluate the growth and spread of gastric cancers. Computed tomography (CT) and positron-emission tomography (PET) scans are often used in this process, commonly referred to as staging.

A laparoscopy, an exploratory surgical technique, enables your doctor to look inside the abdomen and remove tissue samples for a biopsy. This procedure may be used for pathological staging, a method of examining tissue samples under a microscope. Your doctor will use the tissue sample to determine the stage of the gastric cancer.

Gastric cancer staging begins by evaluating three key components of cancer: size, location and spread. In the earliest stages of gastric cancer (stage 0), the cancer has not spread and tumors are localized. In the early stages, the cancer is limited to the inner layer (mucosa) of the stomach.

Later stages are characterized by the growth and spread of cancerous tissues into the layers of the stomach wall and nearby lymph nodes. The cancer has typically grown through the stomach wall and spread into nearby tissues in the most advanced stages (stage IV).

Understanding the TNM System

The American Joint Committee on Cancer's (AJCC) TNM system groups the three key components; T, N and M:

• Tumor - The tumors are rated on a scale 0-4, where T0 indicates no evidence of the primary tumor expanding into local tissue, and the increasing numbers (T1-T4) describe the extent and spread of the tumor into and through the stomach wall. Carcinoma in situ, Tis, describes an early cancer that has not gone beyond to the inner layer (the mucosa).
• Node - If cancer is found in the lymph nodes, the quantity of cancer cells found are rated from N1 to N3. Conditions where the cancer has not spread to the lymph nodes is indicated by N0.
• Metastasized - Cancer that has spread (metastasized) is indicated by M1. Otherwise, M0 is used if there are no signs of metastases.

Each category (T, N and M) is assessed and rated. An X is used to denote insufficient information (the condition of the particular factor cannot be adequately assessed).

Gastric Cancer Stage Grouping

The TNM system assesses the size of the tumor and how far the cancer has spread from the point of origin:

• Stage 0 Gastric Cancer:  The cancer has not grown deeper than the mucosa (inner layer). (Example: Tis, N0, M0).
• Stage I Gastric Cancer:  The cancer has grown beyond the mucosa (inner layer) but has not spread to the muscularis (the muscle layer) (Stage IA). In some cases, the cancer has grown into the muscularis and may or may not have spread to the lymph nodes (Stage IB). (Example: T1, N0, M0 or T2, N1, M0).
• Stage II Gastric Cancer:  The cancer has grown deeper into the stomach wall and may have penetrated the muscle wall. At this stage, it may or may not have reached nearby lymph nodes. (Example: T3, N0, M0).
• Stage III Gastric Cancer:  For gastric cancers, there may be a variety of conditions that are characterized as stage III. The depth the cancer has penetrated the layers of the stomach may vary. The cancer may have metastasized and spread extensively in the nearby lymph nodes. Distant sites, like the lung or liver, remain unaffected. (Example: T1, N1, M0).
• Stage IV Gastric Cancer:  The cancer has either spread throughout gastrointestinal tract or has spread throughout the body to distant sites. (Example: Any T, Any N, M1).

Understanding Gastric Cancer Staging

Staging gastric cancer helps you and your doctor more clearly understand how the cancer has spread within the gastrointestinal system. At Cancer Treatment Centers of America (CTCA), you and your cancer care team will explore treatment options using the information gathered during the staging process and your personal input.

There may be a lot of new information to consider. The CTCA care team is dedicated to ensuring that you clearly understand the process and the variety of treatment options available. With knowledge, expertise and compassion, our doctors clearly communicate the information you need to know.

Taking the Next Steps

When you're ready to learn more, call 888-841-9129 or Chat Now to talk with one of our Oncology Information Specialists. Our representatives are available 24 hours a day, every day of the week. We're ready to help, at any stage.

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