Sometimes staging is not complete until after surgery to remove the tumor and nearby lymph nodes.

These are the stages of stomach cancer:

• Stage 0: The cancer is found only in the inner layer of the stomach. It is carcinoma in situ.
• Stage I is one of the following:
  • The tumor has invaded only the submucosa. (The picture in section 2 shows the layers of the stomach.) Cancer cells may be found in up to 6 lymph nodes.
  • Or, the tumor has invaded the muscle layer or subserosa. Cancer cells have not spread to lymph nodes or other organs.
• Stage II is one of the following:
  • The tumor has invaded only the submucosa. Cancer cells have spread to 7 to 15 lymph nodes.
  • Or, the tumor has invaded the muscle layer or subserosa. Cancer cells have spread to 1 to 6 lymph nodes.
  • Or, the tumor has penetrated the outer layer of the stomach. Cancer cells have not spread to lymph nodes or other organs.
• Stage III is one of the following:
  • The tumor has invaded the muscle layer or subserosa. Cancer cells have spread to 7 to 15 lymph nodes.
  • Or, the tumor has penetrated the outer layer. Cancer cells have spread to 1 to 15 lymph nodes.
  • Or, the tumor has invaded nearby organs, such as the liver or spleen. Cancer cells have not spread to lymph nodes or to distant organs.
• Stage IV is one of the following:
  • Cancer cells have spread to more than 15 lymph nodes.
  • Or, the tumor has invaded nearby organs and at least 1 lymph node.
  • Or, cancer cells have spread to distant organs.
• Recurrent cancer: The cancer has come back (recurred) after a period of time when it could not be detected. It may recur in the stomach or in another part of the body.