Esophageal cancer (staging)
Esophageal cancer staging can depend slightly on whether the tumor is squamous cell or adenocarcinoma subtype. Due to the lack of a serosal layer, esophageal cancer often tends to have mediastinal spread at the time of diagnosis.
Staging
TNM staging
-
T staging
- Tx: primary tumor cannot be assessed
- T0: no evidence of primary tumor
- Tis: high-grade dysplasia
-
T1: invades lamina propria, muscularis mucosae or submucosa
- T1a: invades lamina propria or muscularis mucosae
- T1b: invades submucosa
- T2: invades muscularis propria
- T3: invades adventitia
-
T4: direct extension into adjacent structures
- T4a: (resectable) invades pleura, pericardium or diaphragm
- T4b: (unresectable) invades other structures, e.g. aorta, trachea
-
N staging
- Nx: regional nodes cannot be assessed
- N0: no regional lymph node metastases
- N1: 1-2 regional nodes involved
- N2: 3-6 regional nodes involved
- N3: >7 regional nodes involved
-
M staging
- Mx: metastatic disease cannot be assessed
- M0: no distant metastases
- M1: distant metastases
AJCC staging groups
Staging is dependent on histological subtype, e.g. squamous cell carcinoma or adenocarcinoma. G refers to the grade of tumor and the location is in brackets. As with the TNM classification, X indicates inability to determine grade or location.
Squamous cell carcinoma
- stage 0: Tis N0 M0 G1, X
-
stage I
- stage Ia: T1 N0 M0 G1, X
- stage Ib:
- T1 N0 M0 G2-3
- T2-3 N0 M0 G1,X (lower, X)
-
stage II
- stage IIa
- T2-3 N0 M0 G1,X (upper, middle)
- T2-3 N0 M0 G2-3 (lower, X)
- stage IIB
- T2-3 N0 M0 G2-3 (upper, middle)
- T1-2 N1 M0
- stage IIa
-
stage III
- stage IIIA
- T1-2 N2 M0
- T3 N1 M0
- T4a N0 M0
- stage IIIB
- T3 N2 M0
- stage IIIC
- T4a N1-2 M0
- T4b N- M0
- T- N3 M0
- stage IIIA
- stage IV: T- N- M1
Related Radiopaedia articles
Oesophageal pathology
- esophageal dysmotility
- esophageal tumors
- gastro-esophageal reflux disease
-
esophageal stricture
- benign esophageal stricture
- esophageal web
- esophageal ring
- malignant esophageal stricture
- esophageal stent
- benign esophageal stricture
- trauma
- infectious
- congenital
- gamuts
- mega-esophagus
- pseudoachalasia
- surgical procedures