Staging
Staging is a process that tells a doctor if the cancer has spread and if it has, how far. Staging is one of the most important steps in evaluating treatment options.
Stage 0
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Description
- Abnormal cells found in the inner layer of stomach called "carcinoma in situ." Not yet officially considered cancer.
Treatment
- Endoscopic mucosal resection; total or partial gastrectomy are not usually needed for this.
Stage Ia
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Description
- Cancer is in the superficial layers of the stomach and may have spread to the submucosa (layer of tissue next to the mucosa).
Treatment
- Endoscopic mucosal resection; total or partial gastrectomy may be needed in some cases.
Stage Ib
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Description
- Cancer has grown into the muscle of the wall of the stomach or spread to nearby lymph nodes.
Treatment
- Chemotherapy followed by total or partial gastrectomy. Chemotherapy or chemoradiation following surgery.
Stage IIa
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Description
Cancer has spread to:
- inner layer (mucosa) and 3 to 6 lymph nodes.
- middle (muscle) layer and 1 to 2 lymph nodes.
- outer layer ( subserosa), but not to any lymph nodes.
Treatment
- Chemotherapy followed by total or partial gastrectomy. Chemotherapy or chemoradiation following surgery.
Stage IIb
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Description
Cancer has spread to:
- inner (mucosa) layer and 7 to 15 or more lymph nodes.
- middle (muscle) layer and 3 to 6 lymph nodes.
- outer (subserosa) layer and 1 to 2 lymph nodes.
- the serosa (outer covering of the stomach), but not to any lymph nodes.
Treatment
- Chemotherapy followed by total or partial gastrectomy. Chemotherapy or chemoradiation following surgery.
Stage IIIa
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Description
Cancer has spread t0:
- middle (muscle) layer and 7 to 15 lymph nodes.
- outer (subserosa) layer and 3 to 6 lymph nodes
- the serosa (outer covering of the stomach) and 1 to 6 lymph nodes.
- nearby organs such as the spleen, colon, liver, diaphragm, pancreas, small intestine or kidney
Treatment
- Chemotherapy followed by total or partial gastrectomy. Chemotherapy or chemoradiation following surgery.
Stage IIIb
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Description
Cancer has spread to:
- inner (mucosa) or middle (muscle layer and 16 or more lymph nodes.
- outer layer (subserosa) or serosa (outer covering of the stomach) and 7 to 15 lymph nodes.
- nearby organs or structures and possibly 1 to 6 lymph nodes.
Treatment
- Chemotherapy followed by total or partial gastrectomy. Chemotherapy or chemoradiation following surgery.
Stage IIIc
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Description
Cancer has spread to:
- outer layer (subserosa) or serosa (outer covering of the stomach) and 16 or more lymph nodes.
- nearby organs or structures and 7 or more lymph nodes.
Treatment
- Chemotherapy followed by total or partial gastrectomy. Chemotherapy or chemoradiation following surgery.
Stage IV
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Description
- Cancer has spread to distant organs or parts of the body.
Treatment
- Palliative chemotherapy, clinical trials. Rarely, palliative surgery or radiation therapy may be needed to relieve symptoms.
