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Cancer Staging Systems

Staging of esophagus cancer

Last Update: Sunday January 4th, 2004 7:15 PM GMT

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

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


  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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