If an ulcer is present, its edge tends to be ill-defined or heaped up. Protruding tumors have a better prognosis than spreading tumors. Tumor size does not predict the risk of coexisting metastasis. The smallest tumor may have metastasized to a distant site by the time of discovery. Histologic classification is based on the extent to which the cells are arranged into normal-appearing tubular glands and the degree of cell differentiation.
Histologic classification correlates moderately with gross appearance and prognosis.
Symptoms and Signs Early-stage stomach cancer produces no specific symptoms. Patients and physicians alike tend to dismiss symptoms, often for many months or longer. Detailed inquiry may detect many clues. Pain may suggest peptic ulcer, especially if the cancer involves the lesser curvature. Cancer in the cardiac region of the stomach may obstruct the esophageal outlet and cause dysphagia.