Esophageal cancer stages

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on May 19, 2022.

Making an educated esophageal cancer treatment decision begins with determining the stage, or progression, of the disease. The stage of esophageal cancer is one of the most important factors in evaluating treatment options.

The patient's care team will use a variety of diagnostic tests to evaluate esophageal cancer and develop an individualized treatment plan. After the patient is diagnosed, the care team will review his or her pathology to confirm the diagnosis and staging information and develop a personalized treatment plan. If the patient is diagnosed with a recurrence, the care team will perform comprehensive testing and identify a treatment approach tailored to the patient's needs.

It’s also important to understand that the stage of the cancer may change. The patient's care team will evaluate whether the staging information is affected by the progression, or regression, of the disease.

The stages of esophageal cancer are assigned based on the American Joint Committee on Cancer’s (AJCC) TNM system, a commonly accepted method based on three key components:

T (tumor): This describes the size of the original tumor.

N (node): This indicates whether the cancer is present in the lymph nodes.

M (metastasis): This refers to whether cancer has spread to other parts of the body.

A number (0-4) or the letter X is assigned to each factor. In esophageal cancer staging, as in all cancer staging, a higher number indicates increasing severity. For instance, a T1 score indicates a smaller tumor than a T2 score. The letter X means the information could not be assessed.

Once the T, N and M scores have been assigned, one of these overall stages is assigned:

Stage 1 esophageal cancer: A stage 1 esophageal cancer tumor is small (7 cm or less across) and limited to the esophagus.

Stage 2 esophageal cancer: A stage 2 esophageal cancer tumor has grown larger but still remains within the esophagus. In this stage of the disease, there is no evidence of spread to lymph nodes or distant sites.

Stage 3 esophageal cancer: A stage 3 esophageal cancer tumor has grown beyond the esophagus and may now extend into nearby tissues or organs. The cancer may or may not have spread to nearby lymph nodes.

Stage 4 esophageal cancer: A stage 4 esophageal cancer tumor may be any size and has grown beyond the esophagus. In this stage of esophageal cancer, the disease may have spread to lymph nodes or distant sites like the liver or abdominal cavity.

Next topic: How is esophageal cancer diagnosed?

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