Esophageal Cancer Staging

Thank you William for posting the general staging guidelines. Here is an article with the staging criteria specific to EC which some may find helpful. It was updated in July 2010:

Practice Guidelines in Oncology - v.2.201 0
American Joint Committee on Cancer (AJCC) TNM Classification of Carcinoma of the Esophagus*

Esophageal Cancer

Staging (TNM Classification)
Table 1

Primary Tumor (T):
TX Primary tumor cannot be assessed
TO 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
NO No regional lymph node metastasis
N1 Regional lymph node metastasis

Distant Metastasis (M):
MX Distant metastasis cannot be assessed
MO No distant metastasis
M 1 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 (How to use the TNM classifications in determining the Stage)

Stage 0 Tis N0 M0
Stage I T1 N0 M0
Stage IIA T2/T3 N0 M0

Stage IIB T1/T2 N1 M0


Stage III T3/T4 Any N M0

Stage IV Any T Any N M1a/M1b


**Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original and primary source for this information is the AJCC Cancer Staging Manual, Sixth Edition (2002) published by Springer-Verlag New York. (For more information, visit www.cancerstaging.net.) Any citation or quotation of this material must be credited to the AJCC as its primary source. The inclusion of this information herein does not authorize any reuse or further distribution without the expressed written permission of Springer-Verlag New York on behalf of the AJCC.