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Stage Information for Esophageal Cancer

    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

    The current staging system for esophageal cancer is based largely on retrospective data from the Japanese Committee for Registration of Esophageal Carcinoma. It is most applicable to patients with squamous cell carcinomas of the upper third and middle third of the esophagus, as opposed to the increasingly common distal esophageal and gastroesophageal junction adenocarcinomas.[2] In particular, the classification of involved abdominal lymph nodes as M1 disease has been criticized. The presence of positive abdominal lymph nodes does not appear to carry as grave a prognosis as metastases to distant organs.[3] Patients with regional and/or celiac axis lymphadenopathy should not necessarily be considered to have unresectable disease caused by metastases. Complete resection of the primary tumor and appropriate lymphadenectomy should be attempted when possible.

    References:

    1. Esophagus 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 103-11.
    2. Iizuka T, Isono K, Kakegawa T, et al.: Parameters linked to ten-year survival in Japan of resected esophageal carcinoma. Japanese Committee for Registration of Esophageal Carcinoma Cases. Chest 96 (5): 1005-11, 1989.
    3. Korst RJ, Rusch VW, Venkatraman E, et al.: Proposed revision of the staging classification for esophageal cancer. J Thorac Cardiovasc Surg 115 (3): 660-69; discussion 669-70, 1998.

    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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