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TNM and Stage Groupings > Stomach
Stomach
Primary Tumor (T)
| T Category |
Stage Category Definitions |
| TX |
Primary tumor cannot be assessed |
| T0 |
No evidence of primary tumor |
| Tis |
Carcinoma in situ: intraepithelial tumor without invasion of the lamina propria |
| T1 |
Tumor invades lamina propria, muscularis mucosae, or submucosa |
| T1a |
Tumor invades lamina propria or muscularis mucosae |
| T1b |
Tumor invades submucosa |
| T2 |
Tumor invades muscularis propria |
| T3 |
Tumor penetrates subserosal connective tissue without invasion of visceral
peritoneum or adjacent structures*,**,*** |
| T4 |
Tumor invades serosa (visceral peritoneum) or adjacent structures**,*** |
| T4a |
Tumor invades serosa (visceral peritoneum) |
| T4b |
Tumor invades adjacent structures |
*A tumor may penetrate the muscularis propria with extension into the
gastrocolic or gastrohepatic ligaments, or into the greater or lesser omentum,
without perforation of the visceral peritoneum covering these structures. In
this case, the tumor is classified T3. If there is perforation of the visceral
peritoneum covering the gastric ligaments or the omentum, the tumor should
be classified T4.
**The adjacent structures of the stomach include the spleen, transverse colon,
liver, diaphragm, pancreas, abdominal wall, adrenal gland, kidney, small
intestine, and retroperitoneum.
***Intramural extension to the duodenum or esophagus is classified by the
depth of the greatest invasion in any of these sites, including the stomach.
Regional Lymph Nodes (N)
| N Category |
Stage Category Definitions |
| NX |
Regional lymph node(s) cannot be assessed |
| N0 |
No regional lymph node metastasis* |
| N1 |
Metastasis in 1 to 2 regional lymph nodes |
| N2 |
Metastasis in 3 to 6 regional lymph nodes |
| N3 |
Metastasis in 7 or more regional lymph nodes |
| N3a |
Metastasis in 7 to15 regional lymph nodes |
| N3b |
Metastasis in 16 or more regional lymph nodes |
* A designation of pN0 should be used if all examined lymph nodes are negative,
regardless of the total number removed and examined.
Distant Metastasis (M)
| M Category |
Stage Category Definitions |
| M1 |
Distant metastasis |
No distant metastasis (no pathologic M0; use clinical M to complete stage group)
Anatomic Stage/Prognostic Groups
| Stage |
T |
N |
M |
| 0 |
Tis |
N0 |
M0 |
| IA |
T1 |
N0 |
M0 |
| IB |
T2 |
N0 |
M0 |
| IB |
T1 |
N1 |
M0 |
| IIA |
T3 |
N0 |
M0 |
| IIA |
T2 |
N1 |
M0 |
| IIA |
T1 |
N2 |
M0 |
| IIB |
T4a |
N0 |
M0 |
| IIB |
T3 |
N1 |
M0 |
| IIB |
T2 |
N2 |
M0 |
| IIB |
T1 |
N3 |
M0 |
| IIIA |
T4a |
N1 |
M0 |
| IIIA |
T3 |
N2 |
M0 |
| IIIA |
T2 |
N3 |
M0 |
| IIIB |
T4b |
N0 |
M0 |
| IIIB |
T4b |
N1 |
M0 |
| IIIB |
T4a |
N2 |
M0 |
| IIIB |
T3 |
N3 |
M0 |
| IIIC |
T4b |
N2 |
M0 |
| IIIC |
T4b |
N3 |
M0 |
| IIIC |
T4a |
N3 |
M0 |
| IV |
Any T |
Any N |
M1 |
