Diagnosis Staging and Prognosis

Double-contrast radiography is the simplest means of diagnosing gastric adenocarcinomas. However, it is difficult to distinguish mucosal lesions with radiographs. Endoscopy offers a greater advantage because of direct viewing plus the ability to obtain biopsy and cytological samples.

Cancers are staged according to the extent of tissue and lymph node involvement. The prognosis for adenocarcinomas that are limited to the mucosa can be good. The 5-year survival rate for cancer limited to the mucosa is 90%. Where there is invasion of the submucosa, the 5-year survival rates can drop to 60% and with nodal involvement, down to 30%. Thus, early diagnosis is key to reducing mortality rates and screening programs can be useful in countries with a high incidence of stomach cancer.

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