Stages of esophageal cancer
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.
- T (tumor): It refers to the size of the original tumor.
- N (node): It describes whether cancer has spread to the lymph nodes.
- M (metastasis): It refers to cancer spread to other parts of the body.
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 this stage may have any of these features
|
| IIIB |
Cancer in this stage may have any of these features
|
Cancer in this stage may have any of these features
|
| IVA |
Cancer in this stage may have these features
|
Same |
| IVB | Cancer has spread to other parts of the body. | Cancer has spread to other parts of the body. |
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
https://www.cancer.org/cancer/esophagus-cancer/detection-diagnosis-staging/staging.html
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