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Cancer Health Center

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Esophageal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Esophageal Cancer

The stage determines whether the intent of the therapeutic approach will be curative or palliative.

Definitions of TNM

The AJCC has designated staging by TNM classification to define cancer of the esophagus and esophagogastric junction.[1]

Table 1. Primary Tumor (T)a,b

a Reprinted with permission from AJCC: Esophageal and esophagogastric junction. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 103-15.
b(1) At least maximal dimension of the tumor must be recorded, and (2) multiple tumors require the T(m) suffix.
c High-grade dysplasia includes all noninvasive neoplastic epithelia that was formerly called carcinomain situ, a diagnosis that is no longer used for columnar mucosae anywhere in the gastrointestinal tract.
TX Primary tumor cannot be assessed.
T0 No evidence of primary tumor.
Tis High-grade dysplasia.c
T1 Tumor invades lamina propria, muscularis mucosae, 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.

Table 2. Regional Lymph Nodes (N)a,b

a Reprinted with permission from AJCC: Esophageal and esophagogastric junction. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 103-15.
b Number must be recorded for total number of regional nodes sampled and total number of reported nodes with metastasis.
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.

Table 3. Distant Metastasis (M)a

a Reprinted with permission from AJCC: Esophageal and esophagogastric junction. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 103-15.
M0 No distant metastasis.
M1 Distant metastasis.
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