What Are The Stages of Stomach Cancer? – (TNM Staging) – Part 2

A more detailed explication to the staging of stomach cancer and what it means for a stomach cancer sufferer. Here in – Part 2 – following on from (What Are The Stages of Stomach Cancer? – (TNM Staging) – Part 1 – a more detailed explication of how the different stagings actually work.

The TNM System Grouping

Once the T, N, and M categories have been determined, this information is combined and expressed as a stage or staging, using the number 0 (zero) and Roman numerals I through to IV. This is known as stage grouping. Some stages are split into sub-stages indicated by letters.

Stage 0 – (Tis, N0, M0) Early stage stomach cancer that has not yet grown beyond the inner layer of cells that line the stomach (Tis). No metastasis (spread) to the lymph nodes (N0) or anywhere else (M0). Stage 1A is also known as: Carcinoma in Situ.

Stage 1A – (T1, N0, M0) The cancer has metastasized (spread) beneath the top layer of cells in the mucosa and into the tissues that lies below. This may be either the connective tissue (lamina propria) the thin layer of muscle (muscularis mucosa), or to the submucosa (T1). The has been no metastasis to the lymph nodes (N0) or anywhere else (M0).

Stage 1B – (T1, N1, M0) The cancer has now metastasized into the layer of connective tissue (lamina propria) and into the thin layer of muscle beneath (muscularis mucosa). At this stage the cancer may have metastasized into the submucosa (T1). The cancer has affected between 1 – 2 lymph nodes that are near to the stomach (N1). The cancer has not yet reached any distant tissues or organs (M0).

Stage 11A – (T1, N2, M0) The cancer has now metastasized into the layer of connective tissue (lamina propria) and into the thin layer of muscle beneath (muscularis mucosa). At this stage the cancer may have metastasized into the submucosa (T1). Between 3 – 6 regional lymph nodes have now been affected (N2). The cancer has not yet reached any distant tissues or organs (M0).

or (T2, N1, M0) The cancer has extended its metastasis into the main muscle layer of the stomach wall (muscularis propria [T2]). The cancer has affected between 1 – 2 lymph nodes that are near to the stomach (N1). The cancer has not yet reached any distant tissues or organs (M0).

or (T3, N0, M0) The cancer has now affected the subserosa, although it has not metastasized through all the layers to the outside of the stomach (T3). It has not metastasized to any regional (nearby) lymph nodes (N0) or to any distant tissues or organs (M0).

Stage 11B – (T1, N3, M0) The cancer has metastasized beneath the top layer of cells in the mucosa and into the tissues that lie below (T1). Now 7 regional lymph nodes have been affected (N3). The cancer has not yet reached any distant tissues or organs (M0).

or (T2, N2, M0) The cancer has extended its metastasis into the main muscle layer of the stomach wall (muscularis propria [T2]). Between 3 – 6 regional lymph nodes have been affected (N2). The cancer has not yet reached any distant tissues or organs (M0).

or (T3, N1, M0) The cancer has affected the subserosa, although it has not yet metastasized through all the layers to the outside of the stomach (T3). The cancer has affected between 1 – 2 lymph nodes that are near to the stomach (N1). The cancer has not yet reached to any distant tissues or organs (M0).

or (T4a, N0, M0) The cancer has now metastasized through all the layers of the stomach wall into the outer covering of the stomach (the serosa); however, it has not affected any regional tissues or organs such as: the kidneys, the pancreas, the intestines, or the spleen (T4a). No lymph nodes have been affected (N0), neither any distant sites (M0).