Gastric cancer (TNM staging)

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Gastric cancer staging is routinely performed using the TNM staging system. This article is based on the 7th edition of the TNM classification of malignant tumors.

TNM staging (7edition)

T
  • T1
    • T1a: tumor invades the lamina propria and or muscularis mucosae 
    • T1b: tumor invades submucosa 
  • T2: tumor invades muscularis propria 
  • T3: tumor penetrates the serosa without invasion of the adjacent structures
  • T4
    • T4a: tumor invades serosa (visceral peritoneum)
    • T4b: tumor invades adjacent structures
  N
  • N0: no nodal involvement
  • N1: metastases in 1 to 2 regional lymph nodes
  • N2: metastases in 3 to 6 regional lymph nodes
  • N3
    • N3a: metastases in 7 to 15 regional lymph nodes
    • N3b: metastases in more than 15 regional lymph nodes
M
  • M0: no distant metastases
  • M1: distant metastases