TNM Staging of Gastric Carcinomas | Medicalalgorithms.com

Description

Carcinomas of the stomach may be staged using the TNM classification system.

TNM	Code	Description
T	TX	primary tumor cannot be assessed
	T0	no evidence of primary tumor
	Tis	carcinoma in situ, without involvement of the lamina propria
	T1	tumor invades the lamina propria or submucosa
	T2	tumor invades the muscularis propria or subserosa
	T3	tumor penetrates the serosa (visceral peritoneum) without invasion of adjacent structures
	T4	tumor invades adjacent structures by direct extension
N	NX	regional lymph nodes cannot be assessed
	N0	no regional lymph node metastasis
	N1	metastasis in 1-6 regional lymph nodes
	N2	metastasis in 7-15 regional lymph nodes
	N3	metastasis in > 15 regional lymph nodes
M	MX	distant metastasis cannot be assessed
	M0	no distant metastasis
	M1	distant metastasis

If a tumor involves the gastrocolic ligament, gastrohepatic ligament, greater omentum or less omentum, AND:

• without involvement of the visceral peritoneum, then stage T2.

• with involvement of the visceral peritoneum without invasion of adjacent structure, then stage T3.

Regional lymph nodes: any other lymph node metastasis is considered distant metastasis:

(1) along the greater curvature of the stomach: greater curvature, greater omental, gastroduodenal, right gastroepiploic, left gastroepiploic, pyloric, pancreatoduodenal

(2) pancreatic and splenic regions: pancreatolienal, peripancreatic, splenic hilum

(3) along the lesser curvature of the stomach: lesser curvature, lesser omental, left gastric, parcardial, cardial, cardioesophageal, perigastric, common hepatic, celiac, hepatoduodenal

Stage	TNM
0	Tis N0 M0
IA	T1 N0 M0
IB	T1 N1 M0 T2 N0 M0
II	T1 N2 M0 T2 N1 M0 T3 N0 M0
IIIA	T2 N2 M0 T3 N1 M0 T4 N0 M0
IIIB	T3 N2 M0
IV	T4 N1 M0 T1 N3 M0 T2 N3 M0 T3 N3 M0 T4 N2 MO T4 N3 M0 any T, any N, M1

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Description

Specialty

ICD-10