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Cancer Staging Systems

Staging of esophagus cancer

TNM definition

Primary tumor (T)

• TX: Primary tumor cannot be assessed
• T0: No evidence of primary tumor
• Tis: Carcinoma in situ
• T1: Tumor invades lamina propria or submucosa
• T2: Tumor invades muscularis propria
• T3: Tumor invades adventitia
• T4: Tumor invades adjacent structures

Regional lymph nodes (N)

• NX: Regional lymph nodes cannot be assessed
• N0: No regional lymph node metastasis
• N1: Regional lymph node metastasis

Distant metastasis (M)

• MX: Distant metastasis cannot be assessed
• M0: No distant metastasis
• M1: Distant metastasis
  • Tumors of the lower thoracic esophagus:
    • M1a: Metastasis in celiac lymph nodes
    • M1b: Other distant metastasis
  • Tumors of the midthoracic esophagus:
    • M1a: Not applicable
    • M1b: Nonregional lymph nodes and/or other distant metastasis
  • Tumors of the upper thoracic esophagus:
    • M1a: Metastasis in cervical nodes
    • M1b: Other distant metastasis

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Stage grouping

Stage 0

• Tis, N0, M0

Stage I

• T1, N0, M0

Stage IIA

• T2, N0, M0
• T3, N0, M0

Stage IIB

• T1, N1, M0
• T2, N1, M0

Stage III

• T3, N1, M0
• T4, any N, M0

Stage IV

• Any T, any N, M1

Stage IVA

• Any T, any N, M1a

Stage IVB

• Any T, any N, M1b

References

1. Esophagus. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 91-98.

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