It is difficult to define "extensive" carcinoma of the stomach, for a very small, apparently localized, carcinoma no larger than 1.5 cm. in diameter may be of very high degree of malignancy, and it may cause involvement of the lymph nodes along the greater and lesser curvatures of the stomach that necessitates removal of an extensive portion of the stomach and its attached omentums containing the involved lymph nodes. Were it not for the varying degrees of malignancy, extensive malignant tumors of the stomach might be defined as those which, because of their size, necessitate removing an unusually large part of the stomach and, in some cases, even the entire stomach; or those which because of frequent attachment of the carcinoma to adjacent structures, such as the capsule of the liver or pancreas, or because of involvement of the transverse mesocolon, require that portions of these structures also be removed.
WALTERS W. THE TREATMENT OF EXTENSIVE MALIGNANT LESIONS OF THE STOMACH. JAMA. 1934;103(18):1345-1349. doi:10.1001/jama.1934.02750440005002