Stomach Cancer Stage IV (Metastatic)
Reviewed by Oncology Team, HealOnco | Last updated: 2026-04
What Stage IV (Metastatic) Means
Distant spread to liver, lungs, peritoneum, or distant lymph nodes (M1). Regardless of primary tumor or nodal involvement.
Treatment Approach for Stage IV (Metastatic)
Palliative chemotherapy with fluoropyrimidine-based regimens (FOLFOX, CAPOX). Add targeted therapy if HER2+ (trastuzumab) or ramucirumab. Consider immunotherapy (nivolumab) in PD-L1+ tumors. Supportive care and symptom management critical.
Survival Rates and Prognosis
The 5-year survival rate for stomach cancer at Stage IV (Metastatic) is approximately 5-year survival approximately 5–10% (median overall survival 8–14 months with modern therapy). Survival rates are statistical averages drawn from large patient populations and may not reflect your individual outcome. Factors that influence your specific prognosis include your age, overall health, tumour biology, and how well the cancer responds to treatment.
Important: These numbers are drawn from historical data. Newer treatments available today may improve outcomes beyond what published statistics show. Discuss your individual prognosis with your oncologist.
How Other Stages Compare
| Stage | 5-Year Survival | Treatment |
|---|---|---|
| Stage IA | 5-year survival approximately 70–75% | Endoscopic resection for very small lesions, or partial gastrectomy with D2… |
| Stage IB | 5-year survival approximately 60–65% | Subtotal or total gastrectomy with D2 lymph node dissection. Adjuvant… |
| Stage II | 5-year survival approximately 40–50% | Gastrectomy with D2 dissection. Adjuvant chemotherapy with… |
| Stage IIIA | 5-year survival approximately 25–35% | Neoadjuvant (preoperative) chemotherapy with FOLFOX or CAPOX for 3 cycles,… |
| IIIB | 5-year survival approximately 15–25% | Perioperative chemotherapy (neoadjuvant and adjuvant FOLFOX/CAPOX). For… |
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