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Stage 1

The stage of a cancer tells you how big it is and how far it’s spread. 

What is stage 1 stomach cancer?

Stage 1 stomach cancer usually means that your cancer hasn’t spread beyond the thick muscle in the stomach wall.

It means your cancer hasn’t spread to nearby lymph nodes if the doctors stage you using scans and tests (clinical staging). Or you might have cancer in 1 or 2 nearby lymph nodes if the doctors stage you after an operation (pathological staging).

Stage 1 stomach cancer hasn’t spread to other body parts, structures or distant organs.

This is a simplified description. We have more detailed information below.

Staging systems

Doctors use different systems to stage stomach cancer. This page is about stage 1 cancer, which is part of the number staging system. This system has 5 stages, stage 0 to stage 4.

This page also tells you what stage 1 means in the TNM system. This system describes:

  • the size of the primary tumour (T)
  • whether the cancer has spread to the lymph nodes (N)
  • whether the cancer has spread to another part of the body (M)

How do doctors find out your stage?

There are different ways to find out your stage. Your doctor might use:

  • clinical staging before treatment and if you don't have surgery
  • pathological staging if you do have surgery
  • post neoadjuvant staging if you have chemotherapy before surgery

Clinical staging means the doctor stages you after examining you and looking at test and scan results. Doctors use clinical staging to plan your treatment. It’s also the best way to stage people who aren’t having surgery. You might see your clinical stage written as cTNM.

Pathological staging means the doctor stages you after examining the tissue that the surgeon removes during an operation. This is also called surgical staging. The doctors combine your clinical stage results with the surgical results. Pathological staging is generally a more precise way to find out how far your cancer has spread. Your pathological stage might be different to your clinical stage. You might see your pathological stage written as pTNM.

Post neoadjuvant staging means you have had chemotherapy before surgery (neoadjuvant treatment) and the doctor stages you again after surgery. You might see your post neoadjuvant stage written as ypTNM. 

For stomach cancer, the clinical, pathological, and post neoadjuvant staging are all different. In this section we describe the pathological and clinical stages.

What is stage 1 stomach cancer (clinical staging)?

Clinical staging means your doctor uses test and scan results to stage your cancer.

In clinical staging, stage 1 stomach cancer means the cancer has grown into the inner, supportive or muscle layer of the stomach. There is no cancer in the lymph nodes and it hasn't spread to distant body parts.

In the TNM system, this is the same as one of the following:

  •  T1, N0, M0 
Diagram showing Stage 1 stomach cancer (clinical staging) 1 of 2
  • T2, N0, M0
Diagram showing stage 1 stomach cancer (clinical staging) 2 of 2

What is stage 1 stomach cancer (pathological staging)?

Pathological staging means the doctor stages you after examining the tissue that the surgeon removes during an operation.

In pathological staging, stage 1 stomach cancer means the cancer has grown into the inner, supportive or muscle layer of the stomach. It might have spread to 1 or 2 nearby lymph nodes. But it hasn’t spread to distant organs.

It’s split into 2 groups - stage 1A and stage 1B. 

Stage 1A means the cancer has grown no further than the supportive layer (submucosa) of the stomach wall.

In the TNM system, stage 1A is:

  •  T1, N0, M0 
Diagram showing stage 1A stomach cancer (pathological staging)

Stage 1B means the cancer has grown no further than the muscle layer of the stomach wall. It might have spread into 1 or 2 nearby lymph nodes.

In the TNM system, stage 1B can include:

  • T1, N1, M0
Diagram showing Stage 1B stomach cancer (pathological-staging) 1 of 2
  • T2, N0, M0
Diagram of stage 1B stomach cancer (pathological staging) 2 of 2

Treatment

Surgery

Surgery is the main treatment for stage 1 cancer.

You might have surgery to remove all or part of the stomach.  

You might have chemotherapy after your operation if, after surgery, your surgeon finds your cancer is more advanced than they previously thought.

Very early cancers

For very early, small stage cancers you might be able to have surgery through a thin flexible tube (endoscope) to remove cancer from the lining of the stomach. This is called an endoscopic mucosal resection or EMR. You don't usually need any other treatment.

About other stages

Last reviewed: 
26 Aug 2020
Next review due: 
25 Aug 2023
  • AJCC Cancer Staging Manual (8th Edition)
    M Amin and S Edge.
    Springer, 2017.

  • Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up 
    E Smyth and others, 
    Annals of Oncology, 2016. Volume 27, Pages v38–v49

  • Gastric cancer
    Custem EV. (and others)
    The Lancet, 2016. 5th May S0140-6736(16)30354-3

  • Guidelines for the management of oesophageal and gastric cancer
    Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, the British Society of Gastroenterology and the British Association of Surgical Oncology
    Allum (and others)
    Gut 2011;60:1449-1472

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