Part of Cancer staging guidance sheets

Stomach (ICD10 C16 except C16.0)

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Introduction

This is the data sheet for TNM 8th edition staging of the stomach (ICD10 C16 except C16.0).

For more detailed information regarding TNM staging, please see pages 63-66 of the UICC TNM 8 book or visit the Wiley and UICC website.

Stage groupings

Clinical stage groups

Stage Group	T stage	N stage	M stage
Stage I	T1, T2	N0	M0
Stage IIA	T1, T2	N1, N2, N3	M0
Stage IIB	T3, T4a	N0	M0
Stage III	T3, T4a	N1, N2, N3	M0
Stage IVA	T4b	Any N	M0
Stage IVB	Any T	Any N	M1

Pathological stage groups

Stage Group	T stage	N stage	M stage
Stage 0	Tis	N0	M0
Stage IA	T1	N0	M0
Stage IB	T1	N1	M0
	T2	N0	M0
Stage IIA	T1	N2	M0
	T2	N1	M0
	T3	N0	M0
Stage IIB	T1	N3a	M0
	T2	N2	M0
	T3	N1	M0
	T4a	N0	M0
Stage IIIA	T2	N3a	M0
	T3	N2	M0
	T4a	N1, N2	M0
	T4b	N0	M0
Stage IIIB	T1, T2	N3b	M0
	T3, T4a	N3a	M0
	T4b	N1, N2	M0
Stage IIIC	T3, T4a	N3b	M0
	T4b	N3a, N3b	M0
Stage IV	Any T	Any N	M1

TNM clinical classification

T - primary tumour

T value	Description
TX	Primary tumour cannot be assessed
T0	No evidence of primary tumour
Tis	Carcinoma in situ: intraepithelial tumour without invasion of the lamina propria, high‐grade dysplasia
T1	Tumour invades lamina propria, muscularis mucosae, or submucosa
	T1a - Tumour invades lamina propria or muscularis mucosae
	T1b - Tumour invades submucosa
T2	Tumour invades muscularis propria
T3	Tumour invades subserosa
T4	Tumour perforates serosa (visceral peritoneum) or invades adjacent structures
	T4a - Tumour perforates serosa
	T4b - Tumour invades adjacent structures

N - regional lymph nodes

N value	Description
NX	Regional lymph nodes 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 to 15 regional lymph nodes
	N3b - Metastasis in 16 or more regional lymph nodes

M - distant metastasis

M value	Description
M0	No distant metastasis
M1	Distant Metastasis

TNM pathological classification

pT - primary tumour

The pT categories correspond to the T categories as per above.

pN - regional lymph nodes

The pN categories correspond to the N categories as per above.

Histological examination of a selective neck dissection specimen will ordinarily include 10 or more lymph nodes. Histological examination of a radical or modified radical neck dissection specimen will ordinarily include 15 or more lymph nodes.

pN value	Description
pN0	Histological examination of a regional lymphadenectomy specimen will ordinarily include 16 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0