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Published in: Gastric Cancer 2/2011

01-06-2011 | Special Article

Japanese classification of gastric carcinoma: 3rd English edition

Author: Japanese Gastric Cancer Association

Published in: Gastric Cancer | Issue 2/2011

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Excerpt

Gastric cancer findings are categorized and recorded using the upper case letters T, H, etc. The extent of disease for each parameter is expressed by Arabic numerals following the letter (e.g., T3 H1); where the extent of disease is unknown, X is used. The clinical and pathological classifications are derived from information acquired from various clinical, imaging, and pathological sources (listed in Table 1). The clinical classification (c) is derived at the conclusion of pretreatment assessment before a decision is made regarding the appropriateness of surgery. This classification is an essential guide to treatment selection and enables the evaluation of therapeutic options. The pathological classification (p) is based on the clinical classification supplemented or modified by additional evidence acquired from pathological examination. This informs decision-making regarding additional therapy and provides prognostic information. Where there is doubt regarding the T, N, or M category, the less advanced category should be used.
Table 1
Clinical and pathological classification
Clinical classification (c)
Pathological classification (c)
Physical examination, imaging studies, endoscopic, laparoscopic and surgical findings, biopsy, cytology, biochemical and biological investigations.
Histological examination of surgically or endoscopically resected specimens; peritoneal lavage cytology.
Footnotes
1
SM may be subclassified as SM1 or T1b1 (tumor invasion is within 0.5 mm of the muscularis mucosae) or SM2 or T1b2 (tumor invasion is 0.5 mm or more deep into the muscularis mucosae).
 
2
Tumor extending into the greater or lesser omentum without visceral peritoneal perforation is classified as T3.
 
3
Invaded adjacent structures should be recorded. The adjacent structures of the stomach are the liver, pancreas, transverse colon, spleen, diaphragm, abdominal wall, adrenal gland, kidney, small intestine, and retroperitoneum. Serosal invasion with involvement of the greater and lesser omentum is classified as T4a, not T4b. Invasion of the transverse mesocolon is not T4b unless it extends to the colic vessels or penetrates the posterior surface of the mesocolon.
 
4
In endoscopically resected specimens, capillary invasion is recorded as ly (−) or ly (+), and v (−) or v (+).
 
5
Other sites include retroperitoneal carcinomatosis and the ovaries (Krukenberg).
 
Literature
2.
go back to reference Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47.CrossRefPubMed Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47.CrossRefPubMed
3.
go back to reference Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma–2nd English Edition–Response assessment of chemotherapy and radiotherapy for gastric carcinoma: clinical criteria. Gastric Cancer. 2001;4:1–8. Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma–2nd English Edition–Response assessment of chemotherapy and radiotherapy for gastric carcinoma: clinical criteria. Gastric Cancer. 2001;4:1–8.
Metadata
Title
Japanese classification of gastric carcinoma: 3rd English edition
Author
Japanese Gastric Cancer Association
Publication date
01-06-2011
Publisher
Springer Japan
Published in
Gastric Cancer / Issue 2/2011
Print ISSN: 1436-3291
Electronic ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-011-0041-5

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