Esophageal cancer staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

According to the American Joint Committee on Cancer, there are 4 stages of esophageal cancer based on the tumor spread.

Staging

The American Joint Committee on Cancer has designated staging by TNM classification to define cancer of the esophagus and esophagogastric junction:

Primary Tumor (T)

• TX: Primary tumor cannot be assessed

• T0: No evidence of primary tumor

• Tis: High-grade dysplasia

• T1: Tumor invades lamina propria, muscularis mucosa, or submucosa

• T1a: Tumor invades lamina propria or muscularis mucosae

• T1b: Tumor invades submucosa

• T2: Tumor invades muscularis propria

• T3: Tumor invades adventitia

• T4: Tumor invades adjacent structures

• T4a: Resectable tumor invading pleura, pericardium, or diaphragm

• T4b: Unresectable tumor invading other adjacent structures, such as aorta, vertebral body, trachea, etc.

Regional Lymph Nodes (N)

• NX: Regional lymph nodes cannot be assessed

• N0: No regional lymph node metastasis

• N1: Metastases in 1–2 regional lymph nodes

• N2: Metastases in 3–6 regional lymph nodes

• N3: Metastases in ≥7 regional lymph nodes

Distant Metastasis (M)

• M0: No distant metastasis

• M1: Distant metastasis

American Joint Committee on Cancer stage groupings

Squamous Cell Carcinoma

Stage	T	N	M	Grade	Tumor Location
0	Tis	N0	M0	1, X	Any
IA	T1	N0	M0	1, X	Any
IB	T1	N0	M0	2–3	Any
	T2–3	N0	M0	1, X	Lower, X
IIA	T2–3	N0	M0	1, X	Upper, middle
	T2–3	N0	M0	2–3	Lower, X
IIB	T2–3	N0	M0	2–3	Upper, middle
	T1–2	N1	M0	Any	Any
IIIA	T1–2	N2	M0	Any	Any
	T3	N1	M0	Any	Any
	T4a	N0	M0	Any	Any
IIIB	T3	N2	M0	Any	Any
IIIC	T4a	N1–2	M0	Any	Any
	T4b	Any	M0	Any	Any
	Any	N3	M0	Any	Any
IV	Any	Any	M1	Any	Any

Adenocarcinoma

Stage	T	N	M	Grade
0	Tis	N0	M0	1, X
IA	T1	N0	M0	1–2, X
IB	T1	N0	M0	3
	T2	N0	M0	1–2, X
IIA	T2	N0	M0	3
IIB	T3	N0	M0	Any
	T1–2	N1	M0	Any
IIIA	T1–2	N2	M0	Any
	T3	N1	M0	Any
	T4a	N0	M0	Any
IIIB	T3	N2	M0	Any
IIIC	T4a	N1–2	M0	Any
	T4b	Any	M0	Any
	Any	N3	M0	Any
IV	Any	Any	M1	Any

References

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