What Are the Stages of Gastric Cancer?

The stages of gastric cancer are used to describe how far the cancer has spread in your body. The higher the stage number, the more widespread the cancer is. These stages are important when choosing the best treatments for you.

TNM System

One way to describe the stages of gastric cancer is with the TNM system. This system uses three different codes to describe the size and location of the tumor, whether it has spread to the lymph nodes around the tumor, and whether it can be found in other parts of the body.

In the TNM system, “T” plus a letter or number (0 to 4) is used to describe the size and location of the tumor. The tumor stages for gastric cancer are:

The "N" in the TNM system stands for node. Lymph nodes are tiny organs shaped like beans that can be found throughout the body. Lymph nodes help the body fight infection. Regional lymph nodes are near the stomach, while distant lymph nodes are in other parts of the body. Lymph node stages are:

The "M" in the TNM system is used for cancer that has spread, or metastasized, to other parts of the body. The stages for gastric cancer metastasis are:

Stages 0 to IV

After the T, N, and M categories of your cancer have been identified, your doctor will use this information to assign a stage (0 to IV) to your cancer.

The higher the stage number, the more serious (advanced) the cancer is.

• Stage 0 (carcinoma in situ) - The cancer is found only in the inner layer or lining (mucosa) of the stomach wall (Tis, N0, M0).
• Stage IA - The tumor has spread beyond the mucosa into the connective tissue or support tissue for the mucosa (submucosa). But it has not grown into the stomach’s main muscle layer (muscularis), nearby lymph nodes, or other parts of the body (T1, N0, M0).
• Stage IB - Stage IB gastric cancers fit one of the following profiles:
  
  • The tumor has spread through the mucosa into the connective tissue or submucosa, but not into the muscularis. It has also spread into one to six nearby lymph nodes but not to any other tissues or organs (T1, N1, M0).
  • The tumor has invaded the muscularis and possibly the subserosa. However, it has not spread to any lymph nodes or other tissues or organs (T2a/b, N0, M0).
    
• Stage II - Stage II gastric cancers fit one of the following profiles:
  
  • The tumor has spread through the mucosa into the connective tissue or submucosa and into 7 to 15 nearby lymph nodes. It has not invaded the muscularis (T1, N2, M0).
  • The tumor has invaded the muscularis and possibly the subserosa. It has spread to 1 to 6 nearby lymph nodes. It has not spread to any nearby tissues or organs (T2a/b, N1, M0).
  • The tumor has grown through all of the stomach’s layers. It has not grown into any lymph nodes or nearby tissues or organs (T3, N0, M0).
    
• Stage IIIA - Stage IIIA gastric cancers fit one of the following profiles:
  
  • The tumor has spread into the muscularis and possibly the subserosa. It has also spread to 7 to 15 nearby lymph nodes. It has not spread to any other tissues or organs (T2a/b, N2, M0).
  • The tumor has grown through all of the stomach’s layers and into one to six nearby lymph nodes (T3, N1, M0). It has not spread to any other tissues or organs.
  • The tumor has grown through all of the stomach’s layers and into organs (such as the spleen, intestines, kidneys, or pancreas) near the stomach but not into any lymph nodes or other parts of the body (T4, N0, M0).
    
• Stage IIIB - The tumor has grown through all of the stomach’s layers and into 7 to 15 lymph nodes near the stomach. It has not spread to any other tissues or organs (T3, N2, M0).
• Stage IV -  Stage IV gastric cancers fit one of the following profiles:
  
  • The tumor has grown through all of the stomach’s layers and into organs (such as the spleen, intestines, kidneys, or pancreas) next to the stomach. It has also spread to at least one nearby lymph node but not to any distant organs (T4, N1-2, M0).
  • The tumor may have spread to any or all of the layers of the stomach and it has spread to more than 15 lymph nodes. But it has not spread to any organs in other parts of the body (Any T, N3, M).
  • The tumor may have spread to any other layer of the stomach and it may have spread to any lymph nodes. But it has spread to other organs, such as the liver, lungs, brain, or bones (any T, any N, M1).
    
• Recurrent - The cancer has come back (recurred) in its original site or another part of the body after it was treated.
  

This content has been reviewed and approved by Myo Thant, MD.