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Pathologic Classifications and Staging Systems

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Surgery in the Multimodal Management of Gastric Cancer

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Abstract

Advanced and early gastric carcinomas can be macroscopically and microscopically classified according to different systems. The most widely used are the macroscopic classification proposed by Borrmann and the Lauren histological classification.

The tumor node metastasis (TNM) staging system of the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) is recognized worldwide and its application is simple and reproducible. The seventh TNM staging system for gastric carcinoma is more detailed than the sixth edition. It introduces a clear distinction between tumors invading the muscularis propria (T2) and the subserosa (T3), based on a distinct difference in prognosis. Tumors invading the serosal layer are currently classified as T4a and those invading adjacent organs as T4b. The N groups of the previous edition have been further divided based on the number of involved regional lymph nodes (RLNs). Hence, in the new system, N1 (previously 1–6 RLNs) has been subdivided into N1 (1–2 involved RLNs) and N2 (3–6 involved RLNs), with the former N2 (7–15 involved RLNs) and N3 (> 15 involved RLNs) groups now referred to as N3a and N3b.

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Author information

Authors and Affiliations

  1. Dept. of Surgery, Upper G.I. Surgery Division, University of Verona, Verona, Italy

    Giovanni de Manzoni

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  1. Giovanni de Manzoni
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  2. Marco Catarci
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  3. Alberto Di Leo
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  4. Anna Tomezzoli
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  5. Carla Vindigni
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Editors and Affiliations

  1. Dept. of Surgery Upper G.I. Surgery Division, University of Verona, Verona, Italy

    Giovanni de Manzoni

  2. Dept. of Human Pathology and Oncology Section of General Surgery and Surgical Oncology Translational Research Laboratory, University of Siena, Siena, Italy

    Franco Roviello

  3. Surgical Clinic, Dept. of Medical and Surgical Sciences “Ospedali Riuniti” University Hospital, Polytechnic University of Marche, Ancona, Italy

    Walter Siquini

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© 2012 Springer-Verlag Italia

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de Manzoni, G., Catarci, M., Di Leo, A., Tomezzoli, A., Vindigni, C. (2012). Pathologic Classifications and Staging Systems. In: de Manzoni, G., Roviello, F., Siquini, W. (eds) Surgery in the Multimodal Management of Gastric Cancer. Springer, Milano. https://doi.org/10.1007/978-88-470-2318-5_4

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  • DOI: https://doi.org/10.1007/978-88-470-2318-5_4

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2317-8

  • Online ISBN: 978-88-470-2318-5

  • eBook Packages: MedicineMedicine (R0)

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