Staging

Staging of gastric cancer was proposed by the American Joint Committee on Cancer. To that end, they used the TNM system [84, 266], which is based on the following three criteria: T (tumor) - the primary tumor, N (nodulus) - regional lymph nodes, and M -metastasis. The stage of the disease is thus identified according to the degree of each of the three components:

— Stage IV: T4, N2, M0, or any degree of T and N in the presence of M1

The T criterion is evaluated as follows (O Scheme 3):

— Tx - primary tumor cannot be estimated

— Tins - intraepithelial carcinoma without invasion of the mucous membrane proper

— T1 - invasion of the proper mucous or submu-cous membrane

— T2 - tumor invades the muscular and serous membranes

— T3 - tumor penetrates the serosa without invasion of the adjacent structures

— T4 - tumor invades adjacent tissues and organs (spleen, transverse colon, liver, diaphragm, pancreas, abdominal wall, adrenal glands, small intestine, and retroperitoneal space)

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