Table 1 Summary table of local, nodal and haematogenous spread in gastric cancer

Local spread

•Local spread into adjacent structures (e.g. pancreas, colon, spleen)

Lymph node spread

•Perigastric: pericardial; lesser curvature; greater curvature; suprapyloric

•Extraperigastric: left gastric; common hepatic; coeliac; splenic hilum and artery; hepatic pedicle; retropancreatic; mesenteric root; middle colic; para-aortic

Haematogenous spread

•Most commonly the liver (25% at presentation) and peritoneum

Notes

•Transcoelomic spread can occur through the peritoneum (e.g. Kruckenberg tumours)

•Retropancreatic, para-aortic and mesenteric nodes are classified as M1 metastatic disease

•Nodal disease in GIST tumours is extremely rare