Esophageal Cancer Staging
Esophageal Cancer Stages
Doctors use the term stage to describe how far cancer has grown and whether it has spread to other parts of the body. Knowing the stage helps your care team plan treatment and gives some information about what to expect.
THE BASICS: Esophageal cancer stages range from stage 0 to stage IV. Staging considers how deeply the tumor has grown into the esophageal wall, whether lymph nodes contain cancer, and whether cancer has spread to distant organs. Esophageal cancer staging also considers cancer type and other tumor characteristics.
What is the TNM staging system?
Esophageal cancer is staged using the TNM system.
T: Tumor
The T category describes how deeply the primary tumor has grown through the layers of the esophageal wall or into nearby structures.
N: Nodes
The N category describes whether cancer has spread to nearby lymph nodes and how many lymph nodes contain cancer.
M: Metastasis
The M category describes whether cancer has spread to distant parts of the body.
Doctors combine this information with other tumor characteristics to determine an overall stage.
Stage 0 esophageal cancer
Stage 0 is also called high-grade dysplasia. Severely abnormal cells are found in the innermost lining of the esophagus but have not invaded deeper tissue. Stage 0 can often be treated using endoscopic techniques.
Stage I esophageal cancer
Stage I is an early invasive cancer that remains relatively limited to the esophageal wall. Depending on the exact characteristics of the tumor, treatment may involve endoscopic removal or surgery.
Stage II esophageal cancer
Stage II cancer has generally grown deeper into the esophageal wall or has limited spread to nearby lymph nodes. Treatment often involves more than one approach, such as chemotherapy, radiation, and surgery.
Stage III esophageal cancer
Stage III cancer is more locally advanced. The tumor may have grown through the esophageal wall, involved nearby structures, or spread to several regional lymph nodes. Treatment may include chemotherapy and radiation followed by surgery in appropriate patients. Some people receive definitive chemoradiation without surgery.
Stage IV esophageal cancer
Stage IV means the cancer has spread to distant parts of the body. Common sites include:
Liver
Lungs
Distant lymph nodes
Bones
Other organs
When esophageal cancer spreads to another organ, it is still called metastatic esophageal cancer. For example, esophageal cancer that spreads to the liver is not liver cancer. It is metastatic esophageal cancer involving the liver.
Why can esophageal cancer staging seem complicated?
The exact stage groupings differ depending on whether the tumor is adenocarcinoma or squamous cell carcinoma. Tumor grade and, in some circumstances, tumor location can also affect staging. You do not need to memorize the staging system. Ask your oncologist:
What is my overall stage?
What are my T, N, and M categories?
What does my stage mean for treatment?
Is my cancer considered resectable, meaning it can potentially be removed with surgery?