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Oesophageal cancer staging

Oesophageal cancer staging can depend slightly on whether the tumour is squamous cell or adenocarcinoma subtype. Due to the lack of a serosal layer, oesophageal cancer often tends to have mediastinal spread at the time of diagnosis.


TNM staging
  • T staging
  • 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 tumour 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 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 IV: T- N- M1

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