Current RMA Instruments
| Reasonable Hypothesis SOP | 74 of 2023 |
| Balance of Probabilities SOP | 75 of 2023 |
Changes from previous Instruments
ICD Coding
ICD-10-AM Code: C16
Brief description
Gastric cancer is one of the most common cancers worldwide, though is less common in Western countries. There are a number of sub-types of the disease with the most common being adenocarcinoma. This SOP covers primary epithelial cancers of the cardia, body, antrum and pyloris of the stomach.
Confirming the diagnosis
Histology (from biopsy, an excised specimen, or autopsy) is required to confirm the diagnosis and apply the SOP. Information on whether the primary site is the cardia of the stomach (near the oesophagus), or the rest of the stomach, will be needed to apply some of the SOP factors.
The relevant medical specialist is an oncologist, general surgeon, or gastroenterologist.
Diagnoses covered by SOP
- adeno-, adenosquamous-, chorio-, diffuse-, intestinal-, squamous-, poorly differentiated- and undifferentiated- carcinoma of the stomach; (including mucinous, papillary, signet ring and tubular adenocarcinoma of the stomach)
- carcinoma of the (gastric) cardia
- carcinoma of the stomach
- gastric carcinoma
- linitis plastica
Conditions excluded from SOP
- carcinoid of the stomach#
- gastroblastoma#
- soft tissue sarcoma of the stomach*
- non-Hodgkin lymphoma of the stomach*
- Hodgkin lymphoma of the stomach*
- MALT lymphoma of the stomach - non-Hodgkin lymphoma SOP
- neuroendocrine tumour of the stomach#
- Secondary/metastatic cancer/carcinoma involving the stomach (code to primary cancer site)
* another SOP applies
# non-SOP condition
Clinical onset
The condition typically presents at a late stage. Unintentional weight loss, early satiety (feeling full after consuming only a small amount of food), persistent indigestion and abdominal pain are the most common symptoms. Other presentations can include dysphagia (difficulty swallowing), nausea, vomiting, and black tarry stools (indicating gastrointestinal bleeding).
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Most people present with advanced, incurable disease and have a poor prognosis even with treatment.