How is the primary tumor of gastric cancer staged in the TNM classification system?

Updated: Feb 23, 2021
  • Author: Elwyn C Cabebe, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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The 2010 American Joint Committee on Cancer (AJCC) Cancer Staging Manual presents the following TNM classification system for staging gastric carcinoma [30] :

Primary tumor

See the list below:

  • TX - Primary tumor (T) cannot be assessed
  • T0 - No evidence of primary tumor
  • Tis - Carcinoma in situ, intraepithelial tumor without invasion of 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/organs

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