Prognosis and survival for stomach cancer

If you have stomach cancer, you may have questions about your prognosis. A prognosis is the doctor's best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person (such as age) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for stomach cancer.

Stage is the most important prognostic factor for stomach cancer. When stomach cancer is found in an earlier stage, there is a more favourable outcome.

Tumours that have not grown beyond the stomach wall have a better prognosis than tumours that have grown through the wall.

The number of lymph nodes that the cancer has spread to affects the prognosis. If the cancer has spread to 3 or more lymph nodes, the prognosis is less favourable than if it hasn't spread to the lymph nodes or has only spread to 1 or 2 lymph nodes. If the cancer has spread to 7 or more lymph nodes, the prognosis is even less favourable.

Find out more about stages of stomach cancer.

People diagnosed with HER2-positive stomach cancer have a poorer prognosis because this type of cancer tends to grow quickly (be aggressive).

Find out more about the HER2 status test.

Stomach cancer that is completely removed with no cancer cells in the healthy tissue taken along with the tumour (called negative surgical margins) has a better prognosis than if it cannot be completely removed.

Tumours found in the lower part of the stomach (distal stomach) have a better prognosis than tumours found in the upper (proximal) part of the stomach.

If stomach cancer has moved into small lymph vessels or blood vessels (called lymphovascular invasion, or LVI) or into lymph nodes around the stomach, the prognosis is poorer. These cancers have a much higher risk of spreading to other parts of the body.

Intestinal adenocarcinoma has a better prognosis than diffuse adenocarcinoma.

Low-grade stomach cancers that are well differentiated tend to have a better prognosis because they are less likely to spread (metastasize) or come back (recur) than high-grade stomach cancers.

Find out more about grading stomach cancer.