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staging of gastric carcinoma

Staging: Stage 0 1) Tis N0 M0 2) node negative; limited to mucosa 3) 1% of cases; 90% 5 year survival Stage 1A 1) T1 N0 M0 2) node negative; invasion of lamina propria or submucosa 3) 7% of cases; 59% 5 year survival Stage 1B 1) T2 N0 M0 2) node negative; invasion of muscularis propria 3) 10% of cases; 44% 5 year survival Stage 2 1) T1 N2 M0, T2 N1 M0 -> node positive; invasion beyond mucosa, but within wall 2) T3 N0 M0 -> node negative; extension through the wall 3) 17% of cases; 29% 5 year survival Stage 3a 1) T2 N2 M0, T3 N1 M0, T3 N2 M0 2) node positive; invasion of muscularis propria or through wall 3) 21% of cases; 15% 5 year survival Stage 3b 1) T4 N0 M0, T4 N1 M0 2) node negative; adherence to surrounding tissue 3) 14% of cases; 9% 5 year survival Stage 4 1) T4 N2 M0 -> node positive; adherence to surrounding tissue 2) any T, any N, M1 (distant metastases) 3) 30% of cases; 3% 5 year survival TNM staging [2] 1) T: primary tumor - Tx: primary tumor cannot be assessed - T0: no evidence of primary tumor - Tis: carcinoma in situ: intraepithelilial; no invasion of the lamina propria - T1: tumor invades lamina propria or submucosa - T2: tumor invades muscularis propria or subserosa - T2a: tumor invades muscularis propria - T2b: tumor invades subserosa - T3: tumor penetrates serosa (visceral peritoneum) without invasion of adjacent structures - T4: tumor directly invades other organs or structures 2) N: regional lymph nodes - Nx: regional lymph nodes cannot be assessed - N0: no regional lymph node metastasis - N1: metastasis in 1-6 regional lymph nodes - N2: metastasis in 7-15 regional lymph nodes - N3: metastasis in > 15 regional lymph nodes 3) M: distant metastasis - MX: distant metastasis cannot be assessed - M0: no distant metastasis - M1: distant metastasis

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gastric cancer

General

staging of cancer

References

  1. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 571
  2. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009