The stomach is a J-shaped sac-like organ that connects the esophagus to the duodenum (the first part of the small intestine). It serves as a mixing chamber and holding reservoir for ingested food. It mainly consists of 5 parts – Cardia, Fundus, Body, Antrum, and Pylorus; and 5 layers – Mucosa, Submucosa, Muscularis Propria, Subserosa, and Serosa.
Adenocarcinoma (affecting mucosal cells that lines the innermost lining of the stomach) is the most common type of stomach cancer.
Stomach Cancer Infographics
Risk Factors
Most common risk factors for stomach cancer are Helicobacter pylori infection, dietary factors (in image below), pernicious anemia, chronic atrophic gastritis, genetic and environmemtal factors, etc.
Symptoms and Signs
Most common signs and symptoms are abdominal discomfort/pain, early satiety, nausea, vomiting, unexplained weight loss, black stools, etc.
Investigations
Upper GI endoscopy and biopsy help in confirmation of diagnosis, whereas, endoscopic ultrasound and imaging tests (CT/MRI/PET) are required to stage the disease.
TNM Staging
T Staging
T staging describes the locoregional extent of the tumor. It may be T1 to T4 depending on depth of tumor infiltration into the stomach wall and involvement of surrounding structures.
N and M Staging
N is the nodal staging that may be N0, N1, N2 or N3 depending on the number of regional lymph nodes involved by tumor. And M is the metastatic staging that can be M0 or M1 depending on the site(s) of distant tumor spread.
Treatment
Localised and Locally Advanced Disease
Below is a description of treatment of localized and locally advanced stomach cancer, depending on the TNM staging discussed above.
Metastatic Disease
And here is the treatment for metastatic stomach cancer, that has spread to distant sites.
Stomach Cancer Videos
Types of Stomach Cancer
The video below discusses the types of stomach cancer (intestinal and diffuse) in detail.
Risk Factors
Risk factors for intestinal and diffuse variants of stomach cancer are explained below.
Symptoms and Signs
Symptoms and signs with which stomach cancer presents commonly.
Investigations for Diagnosis and Staging
Following video explains the investigations that are required to confirm the diagnosis and stage the disease.
Anatomy of Stomach
It is important to know the anatomy of stomach and surrounding structures to understand the staging of stomach cancer in a better way.
TNM Staging
TNM staging is explained below in an easy to understand manner.
Localised and Locally Advanced Disease Treatment
Here we will discuss the treatment for stomach cancer that is localised to stomach or invaded locoregionally to nearby structures.
Metastatic Disease Treatment
And below we have discussed the treatment for stomach cancer that has spread to distant sites.