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Treatment Options for Stages II and III Gastric Cancer
Source: Gastric Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: February 21, 2025 · Captured 2026-09-09.
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Context: Treatment of Stages II and III Gastric Cancer
Treatment options for stage II gastric cancer and stage III gastric cancer include:
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Surgical resection (after discussion with a multidisciplinary team regarding the role of perioperative and adjuvant therapy) may include one of the following procedures:Regional lymphadenectomy is recommended with all of the above procedures. Splenectomy is not routinely performed.[1]
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Surgical resection (after discussion with a multidisciplinary team regarding the role of perioperative and adjuvant therapy) may include one of the following procedures:Regional lymphadenectomy is recommended with all of the above procedures. Splenectomy is not routinely performed.[1]
Distal subtotal gastrectomy (if the lesion is not in the fundus or at the cardioesophageal junction).
Surgical resection (after discussion with a multidisciplinary team regarding the role of perioperative and adjuvant therapy) may include one of the following procedures:Regional lymphadenectomy is recommended with all of the above procedures. Splenectomy is not routinely performed.[1]
Proximal subtotal gastrectomy or total gastrectomy (if the lesion involves the cardia).
Surgical resection (after discussion with a multidisciplinary team regarding the role of perioperative and adjuvant therapy) may include one of the following procedures:Regional lymphadenectomy is recommended with all of the above procedures. Splenectomy is not routinely performed.[1]
Total gastrectomy (if the tumor involves the stomach diffusely or arises in the body of the stomach and extends to within 6 cm of the cardia).
Perioperative chemotherapy.[2]
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Postoperative (adjuvant) chemoradiation therapy.[3]
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Postoperative (adjuvant) chemotherapy.
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Neoadjuvant chemoradiation therapy (under clinical evaluation).[4]
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Perioperative chemotherapy and immunotherapy regimens (under clinical evaluation).
No randomized trials of adjuvant chemoradiation versus perioperative chemotherapy have been undertaken.
All newly diagnosed patients with stages II and III gastric cancer should consider clinical trials.
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Preserved source evidence · Not medical advice