Yes; stomach cancer that is found early is often cured: in Japan, more than 9 in 10 people who had surgery at the earliest stage were alive 5 years later [2], and some very early cancers are removed with an endoscope alone [3]. When the cancer has grown deeper but has not spread, chemotherapy before and after surgery improves the chance of cure [4, 7]. Stomach cancer that has reached distant parts of the body usually cannot be cured, but medicines control it, help people live longer and make life more comfortable [7, 9].
Key points
- Finding it early changes everything: in the United States, nearly 8 in 10 people whose cancer is still only in the stomach are alive 5 years later; when the cancer has spread, fewer than 1 in 10 [1].
- Very early stomach cancer can sometimes be removed with an endoscope alone; in a study in Japan, almost all of these people were alive 5 years later [3].
- When the cancer can be operated on but has grown deeper, chemotherapy before and after surgery is standard; and a newer four-drug chemotherapy helped people live longer than an older one [4, 7].
- In advanced stomach cancer, tests on the tumour (HER2, PD-L1, MSI and claudin 18.2) show which medicine fits [7].
- With immunotherapy plus chemotherapy, about 1 in 6 people in one group with advanced disease were alive 5 years later [9].
- In some countries, such as Iran, stomach cancer causes more cancer deaths than any other cancer [12]; it is often found late, and this worsens its outlook [7].
Is stomach cancer curable? What about "malignant" stomach cancer?
Yes, stomach cancer is curable. Every cancer is a "malignant" tumour, so "malignant stomach cancer" simply means stomach cancer, and being malignant does not mean it cannot be treated. A cure means treatment that aims to remove the cancer completely and stop it coming back. This aim is realistic for stomach cancer that has not yet spread to distant parts of the body [1, 2].
The chance of cure depends above all on the stage: how deep the cancer has grown into the stomach wall, whether it has reached the lymph nodes, and whether it has spread to distant parts of the body [2]. The main problem is that stomach cancer is often found late; this is why its overall outlook is still not good [7]. Statistics come from thousands of patients and cannot say exactly what will happen to one person. Read more: What are cancer stages? and Can cancer be cured?; and on other digestive cancers: Is bowel cancer curable? and Is liver cancer curable?
Stomach cancer survival rate: how long do people live, by stage?
| Stage | What it means | About 30 years ago | Today |
|---|---|---|---|
| Only in the stomach | The cancer has not yet grown outside the stomach | Nearly 6 | Nearly 8 |
| Spread nearby | It has reached the lymph nodes or tissue next to the stomach | 2 | Nearly 4 |
| Spread far (stage 4) | It has reached distant places such as the liver, the lining of the abdomen or the lungs | Fewer than 1 (3 in 100) | Fewer than 1 (8 in 100) |
| All stages | All patients together | 2 | Nearly 4 |
Compared with people of the same age without cancer. The "Today" column covers people diagnosed between 2015 and 2021, and the "About 30 years ago" column people diagnosed between 1995 and 1997 [1].
| Stage after surgery | Out of 10 people |
|---|---|
| Stage IA (earliest) | More than 9 |
| Stage IB | More than 8 |
| Stage II | 7 |
| Stage IIIA | More than 5 |
| Stage IIIB | About 3 to 4 |
| Stage IV | Fewer than 2 |
More than 118,000 people who had surgery between 2001 and 2007, staged with the Japanese system used at the time; nearly half of them had stage IA disease. Only people who had surgery are included in these figures [2].
The chance of surviving stomach cancer has grown over the past 30 years, especially when the cancer is still in the stomach or close to it [1]. These numbers are averages, come from people diagnosed several years ago and cannot predict one person's future. To understand these statistics, read: How long do people with cancer live? What 5-year survival means.
Why does finding stomach cancer early matter so much?
In Japan, nearly half of the people who had surgery had cancer at the earliest stage, and more than 9 in 10 of this group were alive 5 years later [2].
In countries where stomach cancer is common, the picture can be very different: in Iran, for example, it causes more cancer deaths than any other cancer [12]. In a review of 33 studies from Iran with more than 17,000 patients, fewer than 2 in 10 were alive 5 years later; this figure has been improving over recent decades but is still low [11]. Overall, stomach cancer has a poor outlook because it is often found late [7].
So know the warning signs, and if your doctor recommends an endoscopy, do not put it off. Read: What are the symptoms of stomach cancer?, Should I be tested for H. pylori? and 5 ways to find cancer early.
Treatment and the chance of cure at each stage
- 1
Very early cancer (only in the inner lining of the stomach)
Sometimes the tumour is removed with an endoscope alone, without removing the stomach. In a study in Japan of 470 people, almost all were alive 5 years later; in about 3 in 10, examination of the removed tissue showed that surgery was also needed, and they had surgery [3].
- 2
Operable cancer that has grown deeper or reached the lymph nodes
The standard treatment is chemotherapy before and after surgery, with surgery to remove the stomach and the nearby lymph nodes [7]. With the four-drug chemotherapy FLOT, half of the patients lived more than 4 years, longer than with an older chemotherapy [4]. In a larger study, adding the immunotherapy drug durvalumab to this chemotherapy made the cancer less likely to come back and helped people live longer [5, 6].
- 3
Stage 4 stomach cancer: can it be treated, and what is the life expectancy?
Stage 4 stomach cancer usually cannot be cured, but it can be treated. The aim is to control the disease, ease symptoms and give a better life [7]. In the United States today, about 8 in 100 people with stomach cancer that has spread are alive 5 years later; nearly three times as many as about 30 years ago [1]. The most important step before treatment starts is testing the tumour [7]:
- HER2-positive: adding the targeted drug trastuzumab to chemotherapy helped people live longer [8].
- PD-L1-positive: the immunotherapy drug nivolumab with chemotherapy; in people with higher PD-L1, about 1 in 6 were alive 5 years later; nearly three times as many as with chemotherapy alone [9].
- Claudin 18.2-positive: the newer drug zolbetuximab with chemotherapy kept the disease under control longer and helped people live longer [10].
- MSI-H: this test is recommended for everyone with stomach cancer, because it changes the type of treatment [7].
Ask your treatment team for help with nutrition and symptom relief from the very start. Read more: What is stage 4 cancer and can it be treated?, What is immunotherapy? and Nutrition during treatment.
What improves the chance of successful treatment?
A timely endoscopy
Cancer that is still only in the stomach has the best chance of cure [1, 2]. If you have warning signs, do not wait to have an endoscopy: Symptoms of stomach cancer.
Tumour tests before treatment
Ask your doctor whether the tumour sample has been tested for MSI and, in advanced disease, for HER2, PD-L1 and claudin 18.2 [7].
Completing chemotherapy before and after surgery
Chemotherapy before and after surgery is part of curative treatment [4, 7]. Report side effects early so that treatment is not interrupted. Read: Complete, on-time treatment without breaks.
H. pylori testing for the family
If one of your first-degree relatives has stomach cancer, talk to your doctor about testing for and treating the bacterium H. pylori: Should I be tested for H. pylori?
Frequently asked questions
Is stomach cancer fatal?
It can be, especially when it is found late; in some countries, such as Iran, it causes more cancer deaths than any other cancer [12]. But stomach cancer that is found early is often cured: in the United States, nearly 8 in 10 people whose cancer is still only in the stomach are alive 5 years later [1].
Can chemotherapy cure stomach cancer?
It depends on the stage. When the cancer can be operated on, chemotherapy before and after surgery, together with the operation itself, improves the chance of cure [4, 7]. In cancer that has spread, chemotherapy alone usually does not remove the disease completely, but it eases symptoms and helps people live longer; and adding a targeted drug or immunotherapy based on tumour tests has improved the results [7, 8, 9].
What is the life expectancy with advanced stomach cancer?
Is stage 3 stomach cancer curable?
Can stomach cancer come back after treatment?
It can. Even after chemotherapy and complete surgery, stomach cancer comes back in some people [5]. This is why you should keep going to follow-up visits and report new symptoms early. Read: What is cancer recurrence and how is it followed up?
Survival and treatment evidence by stage (for doctors)
For physicians
Population survival. SEER (diagnosed 2015–2021): 5-year relative survival for all stages 38%, localised 77%, regional 37% and distant 8%; compared with 22%, 58%, 22% and 3% in 1995–1997 [1]. JGCA nationwide registry (118,367 resected patients, 2001–2007): 5-year OS 71.1%; by pathological stage IA 91.5%, IB 83.6%, II 70.6%, IIIA 53.6%, IIIB 34.8% and IV 16.4%; 44.0% of patients were stage IA; 30-day mortality 0.5% [2]. Meta-analysis of 33 Iranian studies (17,207 patients): 1-, 3- and 5-year survival 58.9%, 29.9% and 18.2% [11].
Early cancer. JCOG0607 (470 patients with intestinal-type cT1a disease meeting the expanded ESD criteria): en bloc resection 99.1%; additional gastrectomy in 28% who did not meet the curative resection criteria; 5-year OS 97.0% (95% CI 95.0 to 98.2), with no recurrence in the 317 patients with curative resection [3].
Resectable locally advanced disease. NCCN 2025: perioperative chemotherapy for T2 or higher, any N, category 1 [7]. FLOT4 (716 patients with cT2+ or cN+ disease): median OS 50 months with FLOT vs 35 months with ECF/ECX (HR 0.77; 95% CI 0.63 to 0.94), with similar serious adverse events (27% in both groups) [4]. MATTERHORN (948 patients with stage II to IVA disease; durvalumab 1500 mg every 4 weeks with 4 cycles of FLOT, 2 before and 2 after surgery, followed by 10 cycles of durvalumab): 2-year EFS 67.4% vs 58.5% (HR 0.71), pathological complete response 19.2% vs 7.2% [5]; in a later analysis, OS improved (HR 0.78; 95% CI 0.63 to 0.96; P=0.021) [6].
Advanced disease. NCCN 2025: MSI/MMR testing for all newly diagnosed patients, and HER2, PD-L1 and CLDN18.2 in advanced disease; systemic therapy provides palliation, improves survival and enhances quality of life [7]. ToGA (HER2-positive): median OS 13.8 months with trastuzumab plus chemotherapy vs 11.1 months (HR 0.74) [8]. CheckMate 649 (HER2-negative, minimum follow-up 60.1 months): in CPS ≥5, OS HR 0.71 and 5-year OS 16% with nivolumab plus chemotherapy vs 6% with chemotherapy; grade 3/4 treatment-related adverse events 60% vs 45% [9]. SPOTLIGHT (CLDN18.2-positive, HER2-negative): zolbetuximab plus mFOLFOX6, median PFS 10.61 vs 8.67 months (HR 0.75) and OS HR 0.75 [10]. Regimens: FLOT and nivolumab with CAPOX or FOLFOX.
Scientific evidence
Scientific evidence
7 itemsPerioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial
Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial
Nivolumab plus chemotherapy as first-line treatment for advanced gastric, gastroesophageal junction, and esophageal adenocarcinoma: 5-year follow-up results from CheckMate 649
Gastric Cancer, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology
Perioperative durvalumab plus fluorouracil, leucovorin, oxaliplatin, and docetaxel for resectable gastric and gastro-oesophageal junction adenocarcinoma (MATTERHORN): final results of overall survival and event-free survival by pathological response in a global, randomised, double-blind, placebo-controlled, multicentre, phase 3 trial
Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): a multicentre, randomised, double-blind, phase 3 trial
Perioperative Durvalumab in Gastric and Gastroesophageal Junction Cancer
Related cancer types
Related questions
References
12 referencesShow all references, 8 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
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- 4Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial
- 5
- 6Perioperative durvalumab plus fluorouracil, leucovorin, oxaliplatin, and docetaxel for resectable gastric and gastro-oesophageal junction adenocarcinoma (MATTERHORN): final results of overall survival and event-free survival by pathological response in a global, randomised, double-blind, placebo-controlled, multicentre, phase 3 trial
- 7
- 8
- 9
- 10Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): a multicentre, randomised, double-blind, phase 3 trial
- 11
- 12
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