Stomach Cancer: Stages

What does stage of cancer mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. He or she can also see if the cancer has grown into nearby areas, and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

What are the stages of stomach cancer?

The stages of stomach cancer include the following:

Stage 0 (also known as carcinoma in situ): The cancer is found only in the innermost layer of the stomach wall (mucosa). It has not spread anywhere else. 

Stage I: The cancer is not in the distant organs. But it has grown in one of these ways:

  • The cancer spread deeper than the mucosa. But it's not in the lymph nodes or other organs.

  • It's in the inner layers of the stomach wall. It has grown deeper than just the mucosa and has spread to up to one or two lymph nodes very close to the tumor.

  • The cancer is in the inner layers of the stomach wall. It has also invaded the main outer muscle layer. It has not spread to lymph nodes or other organs.

Stage II: The cancer is not in the distant organs. But it has grown in one of these ways:

  • It’s limited to the inside layers of the stomach, has not grown through the outer muscular wall, and has spread to three to six lymph nodes very close to the tumor.

  • It has grown into the outer muscle layer of the stomach wall (muscularis propria) and has spread to one to two nearby lymph nodes.

  • The cancer has gone through the outermost layer of the stomach wall, but not through the lining outside the stomach. It has not spread to lymph nodes or other organs.

  • It’s only in the inside layers of the stomach itself, but has spread to seven or more lymph nodes close to the tumor.

  • The cancer has grown into the outermost muscle layer of the stomach wall. It’s also spread to three to six lymph nodes that are near the tumor.

  • It’s found in the inside layers, but has not grown through all the layers of the stomach wall. Cancer is also found in one or two nearby lymph nodes.

  • The cancer has gone completely through all the layers of the stomach wall, including the lining outside the stomach. But it’s not in nearby lymph nodes, organs, or other tissues.

Stage III: The cancer is not in distant organs and has grown in one of these ways:

  • It has grown through all the layers of the stomach, is in the outermost covering layer of the stomach wall (serosa), and has spread to one or two lymph nodes near the tumor. But it’s not in other nearby organs or tissues.

  • It’s through the lining of the stomach and in the layer of the stomach wall (subserosa), but it’s not through all the layers to the outside of the stomach. It has spread to three to six nearby lymph nodes.

  • It has penetrated through the inside layers of the stomach wall to the main muscle layer of the stomach. The cancer has spread to seven or more lympph nodes very close to the tumor.

  • It has grown through the inside layers of the stomach wall to the subserosa layer, but it has not grown through all the layers (including the main muscle layer) or the outside lining. The cancer has also spread to seven or more lymph nodes very close to the tumor.

  • The cancer has grown through the layers of the stomach wall, including the serosa, and has spread to three to six lymph nodes.

  • The cancer has gone through all the layers of the stomach wall and the outside lining. It has spread to nearby organs and tissues. These may include the blood vessels, intestines, or liver. The cancer may also have spread to one or two nearby lymph nodes.

  • The tumor has grown through all the layers of the stomach wall, but has not spread to nearby organs and tissues. It has spread to seven or more nearby lymph nodes.

  • The tumor has penetrated through all the layers of the stomach wall and has spread to nearby organs and tissues. It has also spread to three or more nearby lymph nodes.

Stage IV: The cancer has spread beyond the stomach to distant parts of your body. These may include your lungs, bones, or brain.

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

Talking with your healthcare provider

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Make sure to ask any questions or talk about your concerns.