Staging

  • Todd Demmy, MD, FACS, Clinical Chair, Department of Thoracic Surgery

Grading and Staging of Esophageal Tumors

If tests or a biopsy show that cancer is present, your doctor needs to pinpoint the extent (or stage) of the disease, to choose the best treatment. When esophageal cancer spreads, it's often found in nearby lymph nodes. If cancer has reached these nodes, it may also have spread to other lymph nodes, the bones, or other organs, such as the liver and lungs.

Cancer of the esophagus is evaluated by the following stages:

  • Stage 0: Abnormal cells are found only in the inner layer of the esophagus. It's called carcinoma in situ.
  • Stage I: The cancer has grown through the inner layer to the submucosa.
  • Stage II is one of the following:
    • The cancer has grown through the inner layer to the submucosa, and cancer cells have spread to lymph nodes.
    • Or, the cancer has invaded the muscle layer. Cancer cells may be found in lymph nodes.
    • Or, the cancer invades the adventitia (periesophageal connective tissue).
  • Stage III is one of the following:
    • The cancer has grown through the outer layer, and cancer cells have spread to lymph nodes.
    • Or, the cancer has invaded nearby structures, such as the airways. Cancer cells may have spread to lymph nodes.
  • Stage IV: Cancer cells have spread to distant organs, such as the liver.