Staging and prognosis for stomach cancer

Test results will help show whether you have stomach cancer, and whether it has spread from the original site to other parts of the body. Working out how far the cancer has spread is called staging and it helps your health care team decide the best treatment for you.

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The TNM staging system is the method most commonly used to describe the different stages of stomach cancer. Each letter is assigned a number to describe the cancer.

TNM staging system

  • T (Tumour) 0–4: Indicates how far the tumour has grown into the stomach wall. The higher the number, the deeper the tumour.
  • N (Nodes) 0–3: Shows if the cancer has spread to nearby lymph nodes. N0 means the cancer has not spread to the lymph nodes; N1, N2 or N3 indicate increasing node involvement.
  • M (Metastasis) 0–1: Indicates if the cancer has spread (metastasised) to other parts of the body. M0 means the cancer has not spread; M1 means the cancer has spread.

Based on the TNM numbers, the doctor then works out the overall stage (I–IV) of the cancer:

  • Stage I – tumours are found only in the stomach wall lining (known as early or limited disease).
  • Stages II and III – tumours have spread deeper into the layers of the stomach walls and to nearby lymph nodes (known as locally advanced disease).
  • Stage IV – tumours have spread beyond the stomach wall to other parts of the body, such as the bones or lungs, or to distant lymph nodes (known as advanced or metastatic disease).

If you are finding it hard to understand staging, ask someone in your medical team to explain it in a way that makes sense to you. You can also call Cancer Council 13 11 20 to clarify the information you have been given and what it means.


Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of the disease. Instead, your doctor can give you an idea about the general prognosis for people with the same type and stage of cancer.

Generally, the earlier stomach cancer is diagnosed, the better the chances of successful treatment. If cancer is found after it has spread from the primary tumour site, the prognosis is not as good.

Test results, the type of cancer, the rate and depth of tumour growth, the likelihood of response to treatment, and factors such as your age, level of fitness and medical history are important in assessing your prognosis. These factors will also help your doctor advise you on the best treatment options.

This information was last reviewed in September 2017
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