Esophageal and esophagogastric junction neuroendocrine tumor (staging)

Esophageal and esophagogastric junction neuroendocrine tumor staging refers to TNM staging of epithelial cancers other than the squamous cell carcinoma and adenocarcinoma groups located in the esophagus or esophagogastric junction (including tumors whose center is within the proximal 2 cm of the gastric cardia).

Specific histologies included are well-differentiated (G1) neuroendocrine tumor (carcinoid), moderately differentiated (G2) neuroendocrine tumor, neuroendocrine carcinoma, large cell neuroendocrine carcinoma, and small cell neuroendocrine carcinoma. The individual TNM category definitions are identical to that of other histologies of esophagus and esophagogastric junction cancers, but there is no prognostic stage grouping at this time. The following article reflects the 8^th edition published by the American Joint Committee on Cancer, which is used for staging starting 1 January 2018 ^1,2.

For the other histological types, please refer to their dedicated staging articles:  

• esophageal and esophagogastric junction squamous cell carcinoma (staging)
• esophageal and esophagogastric junction adenocarcinoma (staging)

Primary tumor (T)

• Tx: primary tumor cannot be assessed
• T0: no evidence of primary tumor
• Tis: high-grade dysplasia (malignant cells confined to the epithelium by the basement membrane)
• T1: tumor invades lamina propria, muscularis mucosae or submucosa
  • T1a: invades lamina propria or muscularis mucosae
  • T1b: invades submucosa
• T2: tumor invades muscularis propria
• T3: tumor invades adventitia
• T4: tumor invades adjacent structures
  • T4a: tumor invades pleura, pericardium, azygos vein, diaphragm, or peritoneum
  • T4b: tumor invades other adjacent structures, e.g. aorta, vertebra, or trachea

Regional lymph node (N)

• Nx: regional nodes cannot be assessed
• N0: no regional lymph node metastasis
• N1: metastasis in 1-2 regional nodes
• N2: metastasis in 3-6 regional nodes
• N3: metastasis in ≥7 regional nodes

The regional lymph node stations are defined separately: esophageal lymph node stations.

​Distant metastasis (M)

• cM0: no distant metastasis
• cM1: distant metastasis clinically present
• pM1: distant metastasis pathologically (microscopically) confirmed