Gastric cancer (TNM staging)

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)

  • 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
  • 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
  • M0: no distant metastases
  • M1: distant metastases