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

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.
TXPrimary tumor cannot be assessed.
T0No evidence of primary tumor.
TisHigh-grade dysplasia.c
T1Tumor invades lamina propria, muscularis mucosae, or submucosa.
T1aTumor invades lamina propria or muscularis mucosae.
T1bTumor invades submucosa.
T2Tumor invades muscularis propria.
T3Tumor invades adventitia.
T4Tumor invades adjacent structures.
T4aResectable tumor invading pleura, pericardium, or diaphragm.
T4bUnresectable 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.
NXRegional lymph nodes cannot be assessed.
N0No regional lymph node metastasis.
N1Metastases in 1–2 regional lymph nodes.
N2Metastases in 3–6 regional lymph nodes.
N3Metastases 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.
M0No distant metastasis.
M1Distant metastasis.

Table 4. Anatomic Stage/Prognostic Groupsa

Squamous Cell Carcinomab
StageTNMGradeTumor Locationc
HGD = high-grade dysplasia.
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 Or mixed histology, including a squamous component or not otherwise specified.
c Location of the primary cancer site is defined by the position of the upper (proximal) edge of the tumor in the esophagus.
0Tis (HGD)N0M01, XAny
IAT1N0M01, XAny
IBT1N0M02–3Any
T2–3N0M01, XLower, X
IIAT2–3N0M01, XUpper, middle
T2–3N0M02–3Lower, X
IIBT2–3N0M02–3Upper, middle
T1–2N1M0AnyAny
IIIAT1–2N2M0AnyAny
T3N1M0AnyAny
T4aN0M0AnyAny
IIIBT3N2M0AnyAny
IIICT4aN1–2M0AnyAny
T4bAnyM0AnyAny
AnyN3M0AnyAny
IVAnyAnyM1AnyAny
Adenocarcinoma
StageTNMGrade
0Tis (HGD)N0M01, X
IAT1N0M01–2, X
IBT1N0M03
T2N0M01–2, X
IIAT2N0M03
IIBT3N0M0Any
T1–2N1M0Any
IIIAT1–2N2M0Any
T3N1M0Any
T4aN0M0Any
IIIBT3N2M0Any
IIICT4aN1–2M0Any
T4bAnyM0Any
AnyN3M0Any
IVAnyAnyM1Any
1|2

WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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