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Stomach Cancer Staging

Doctors need to know the stage of stomach cancer you have in order to decide which treatment to recommend. The stage is based on the size and extent of the tumor, the number of lymph nodes involved, and how far the cancer has spread (metastasized). Your doctor gets this information from your biopsies, imaging tests, examination of the contents removed during surgery, and any other exams done. Staging studies for stomach cancer may include a CT scan, an endoscopic ultrasound, and laparoscopy (with or without ultrasound).

Staging for stomach cancer may not be complete until after surgery. The surgeon takes out nearby lymph nodes and may take samples of tissue from other areas in your abdomen (biopsies). To check for cancer cells, a pathologist examines all contents removed during surgery. Pathologists are specially trained doctors who interpret the changes caused by disease in tissues. Decisions about treatment after surgery depend on these findings.

The most common way doctors describe the stage of stomach cancer is with the TNM system.

The TNM System

When you receive a diagnosis of stomach cancer, the doctor needs to know which stage the cancer is in. The American Joint Committee on Cancer has developed a standard system of describing the extent of a cancer's growth, which is the stage. This system is known as the TNM System. The TNM System is the most common one used to stage stomach cancer.

The letters in the TNM System stand for:

Stage Groupings of Stomach Cancer

Once the doctor determines your T, N, and M stages, stage grouping is created. Stage grouping is used to determine your overall disease stage. It is expressed most often in Roman numerals from 0 (the least advanced) to IV (the most advanced stage). According to the National Cancer Institute, the following stage groupings are used for staging stomach cancer.

Recurrent disease. Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the stomach or in another part of the body, such as the liver or lymph nodes.

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