What Are the Stages of Esophageal Cancer?

Reviewed on 4/30/2021

Stages of esophageal cancer

Esophageal cancer
In this staging system, three types of key information are used.

The staging system most often used for esophageal cancer is the American Joint Committee on Cancer (AJCC) TNM system. In this staging system, three types of key information are used.

A number (0-4) or the letter X is allocated to each factor. A higher number means the cancer is advanced. For instance, a T1 score refers to a smaller tumor than a T2 score. The letter X indicates that information could not be assessed. After assigning T, N, or M category to a person, this information is combined in a process called stage grouping to assign an overall stage. Factors that determine the stages of esophageal cancer include

  • The size of the tumor
  • Invasion of cancer to the lymph nodes or other parts of the body
  • The location of the cancer
    • Mucosa (inner layer)
    • Submucosa (second layer)
    • Muscularis propria (third layer)
    • Adventitia (outer layer)

Esophageal cancer can be broadly classified as

  • Superficial cancer: It is limited to the lining of the esophagus (usually treated with endoscopic treatments or surgery).
  • Local advanced: Patients with these tumors are treated with a combination of chemotherapy and radiation, followed by surgery.
  • Metastatic disease: Patients with this disease are generally treated with chemotherapy alone.
Stages Squamous Cell Carcinoma Adenocarcinoma
0 Cancer is only in the superficial lining of the esophagus. This stage is known as high-grade dysplasia. Same
IA Cancer is invading the tissue under the epithelium (lamina propria and muscularis mucosa). It has not spread to any lymph nodes or distant organs. Same
IB Cancer is growing into the lamina propria, muscularis mucosa, or submucosa. It has not spread to any lymph nodes or distant organs. Same
IC This stage does not exist for squamous cell cancer. Cancer is growing deeper than stage IB into the lamina propria, muscularis mucosa, submucosa, or muscularis propria. It has not spread to the nearby lymph nodes or distant organs.
IIA

Cancer has spread to muscularis propria. It has not spread to the nearby lymph nodes or distant organs.

Or

Cancer is growing into the adventitia but has spread to the nearby lymph nodes or distant organs.

Cancer is growing into the adventitia but has not spread to the nearby lymph nodes or distant organs.
IIB Cancer is growing into the adventitia but has not spread to the nearby lymph nodes or distant organs. Cancer is growing into the lamina propria, muscularis mucosa (the tissue under the epithelium) of the submucosa and has spread to one or two nearby lymph nodes. It has not spread to distant organs.
IIIA

Cancer in this stage may have any of these features

  • Cancer in the mucosa or submucosa and up to six nearby lymph nodes
  • Cancer in the muscularis propria and one or two nearby lymph nodes

Cancer in this stage may have any of these features

  • Cancer in the mucosa or submucosa and up to six nearby lymph nodes
  • Cancer in the muscularis propria and one or two nearby lymph nodes
IIIB

Cancer in this stage may have any of these features

  • Cancer in the adventitia and one or two nearby lymph nodes
  • Cancer in the muscularis propria or adventitia and three to six nearby lymph nodes
  • Cancer has spread to the chest, abdomen, heart, and lungs with no more than two lymph nodes

Cancer in this stage may have any of these features

  • Cancer in the muscularis propria and three to six nearby lymph nodes
  • Cancer in the adventitia and no more than six nearby lymph nodes
  • Cancer has spread to the chest, abdomen, heart, and lungs with no more than two lymph nodes
IVA

Cancer in this stage may have these features

  • Cancer in the chest (involving the pericardium and pleura), abdomen, heart and lungs, and three to six nearby lymph nodes
  • Cancer has invaded the nearby areas such as the trachea or spine but no more than six lymph nodes
  • Cancer in seven or more nearby lymph nodes
Same
IVB Cancer has spread to other parts of the body. Cancer has spread to other parts of the body.

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References
https://stanfordhealthcare.org/medical-conditions/cancer/esophageal-cancer/about-this-condition/stages.html

https://www.cancer.org/cancer/esophagus-cancer/detection-diagnosis-staging/staging.html

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