by Mimi Ashworth

Created on: November 18, 2007

Stomach cancer, also known as gastric cancer, is a disease where normal cells in the stomach tissues become cancerous and grow out of control. The system most often used to stage stomach cancer in the United States is the American Joint Commission on Cancer (AJCC) TNM system. The TNM staging system is comprised of letters and numbers where:

T describes how far the Tumor has grown into the wall of the stomach and into nearby organs.

N describes the spread to nearby (regional) lymph Nodes.
M indicates whether the cancer has Metastasized (spread) to other organs of the body

The letters TNM are normally preceded by the following to supply additional information:

The numbers 0-4 indicate the increasing severity.
The letter X means "cannot be assessed" because the information is not available.
The letters "is" mean "carcinoma in situ," which means the tumor is contained within the top layer of mucosa cells and has not yet invaded deeper layers of tissue.

Stages of Stomach Cancer

So what are the stages of stomach cancer? There are four stages of stomach cancer: Stage 0, Stage 1, Stage 2, Stage 3 and Stage 4.

Stage 0

The cancer is contained within the inner most layer of the stomach wall. No spread to the lymph nodes and no distant metastasis. The TNM combination assigned to this stage is TIS, N0, M0.

Stage 1

The cancer has moved beyond the inner most layer of the stomach wall. The three combinations of TNM features assigned to this stage are:

Stage 1A (T1, N0, M0): The cancer has invaded the second or third layers of the stomach and has not spread to the lymph nodes near the location of the cancer.

Stage 1B (T1, N1, M0): The cancer is located in the second layer of the stomach and has spread to at least 6 lymph nodes close to the tumor but not to any other tissues or organs.

Stage 1B (T2a/b, N0, M0): The cancer is located in the middle layer of the stomach and has not spread to any other tissues or to any lymph nodes.

Stage 2

This stage is more advanced than the previous and the cancer has spread to the second and third layers of the stomach. The three combinations of TNM features assigned to this stage are:
T1, N2, M0: The cancer is in the second layer of the stomach wall and has spread to at least 7-15 lymph nodes near the stomach.

T2a/b, N1, M0: The cancer is in the third layer of the stomach and has spread to at least 1-6 lymph nodes and has not spread to any nearby tissues or organs.

T3, N0, M0: The cancer has spread through all the layers of the stomach. It has not spread to any

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