Based on AJCC gastric cancer staging:
pT2 N0 Mx
侵及肌层，无淋巴结转移, 远端转移未知
It would be nice to have PET/CT scan to evaluate distant metastasis
if there is no distant metastasis, the final stage would be Stage IB
still considered fairly early.
There are a few ongoing clinical trials. The optimal
regimen for postoperative chemoradiotherapy has not yet been established.
The common chemotherapy drugs includes:
5-FU, VBL, CTX, MeCCNU, Ara-C
FYI:
Primary tumor (T)
TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
Tis: Carcinoma in situ: intraepithelial tumor without invasion of the lamina
propria
T1: Tumor invades lamina propria or submucosa
T2: Tumor invades the muscularis propria or the subserosa*
T3: Tumor penetrates the serosa (visceral peritoneum) without invading
adjacent structures**,***
T4: Tumor invades adjacent structures***
*Note: A tumor may penetrate the muscularis propria with extension into the
gastrocolic or gastrohepatic ligaments or into the greater or lesser omentum
without perforation of the visceral peritoneum covering these structures.
In this case, the tumor is classified T2. If there is perforation of the
visceral peritoneum covering the gastric ligaments or omentum, the tumor
should be classified T3.
**Note: The adjacent structures of the stomach include the spleen,
transverse colon, liver, diaphragm, pancreas, abdominal wall, adrenal gland,
kidney, small intestine, and retroperitoneum.
***Note: Intramural extension to the duodenum or esophagus is classified by
the depth of greatest invasion in any of these sites, including stomach.
Regional lymph nodes (N)
The regional lymph nodes are the perigastric nodes, found along the lesser
and greater curvatures, and the nodes located along the left gastric, common
hepatic, splenic, and celiac arteries. For pN, a regional lymphadenectomy
specimen will ordinarily contain at least 15 lymph nodes. Involvement of
other intra-abdominal lymph nodes, such as the hepatoduodenal,
retropancreatic, mesenteric, and para-aortic, is classified as distant
metastasis.
NX: Regional lymph node(s) cannot be assessed
N0: No regional lymph node metastasis
N1: Metastasis in 1 to 6 regional lymph nodes
N2: Metastasis in 7 to 15 regional lymph nodes
N3: Metastasis in more than 15 regional lymph nodes
Distant metastasis (M)
MX: Distant metastasis cannot be assessed
M0: No distant metastasis
M1: Distant metastasis
Anatomic stage/prognostic groups
Stage 0 Tis N0 M0
Stage IA T1 N0 M0
Stage IB T2 N0 M0
T1 N1 M0
Stage IIA T3 N0 M0
T2 N1 M0
T1 N2 M0
Stage IIB T4a N0 M0
T3 N1 M0
T2 N2 M0
T1 N3 M0
Stage IIIA T4a N1 M0
T3 N2 M0
T2 N3 M0
Stage IIIB T4b N0 M0
T4b N1 M0
T4a N2 M0
T3 N3 M0
Stage IIIC T4b N2 M0
T4b N3 M0
T4a N3 M0
Stage IV Any T Any N M1
