NCCN Guidelines for Patients® | Esophageal Cancer - page 16

16
NCCN Guidelines for Patients
®
: Esophageal Cancer
Version 1.2013
Part 2: Cancer staging
The pathologist also assigns the cancer a histologic
grade. This score is a sign of how fast the cancer will
likely grow and spread. Higher scores likely mean that
the cancer will grow and spread fast. The grades for
esophageal cancer are:
GX
– the grade can’t be assessed (often because
there’s not enough tissue),
G1
– the cancer cells look similar to healthy cells,
G2
– the cancer cells are somewhat different than
healthy cells,
G3
– the cancer cells barely look like healthy
cells, and
G4
– the cancer cells don’t look anything like
healthy cells.
2.3 TNM scores
The AJCC (
A
merican
J
oint
C
ommittee on
C
ancer)
staging system is used to stage esophageal cancer. In
this system, the letters T, N, and M describe a different
area of cancer growth. Your doctors will assign a score
to each letter based on the clinical staging tests and
pathology review. These scores will be combined to
assign the cancer a stage.
T = Tumor
The T score tells into which tissues the primary tumor
has grown. Esophageal cancers first grow through the
wall of the esophagus and then into other tissues next to
the esophagus. See Figure 5. T scores for esophageal
cancer include:
Tis
means there are abnormal cells that haven’t
grown beyond the epithelium.
T1
tumors have invaded the lamina propria,
muscularis mucosae, or submucosa.
T1a
tumors have invaded the lamina propria or
muscularis mucosae.
T1b
tumors have invaded the submucosa.
T2
tumors have invaded the muscularis propria.
T3
tumors have invaded the adventitia.
T4
tumors have invaded nearby tissues.
T4a
tumors have invaded pleura, pericardium or
invaded the diaphragm and can be treated by
surgery.
T4b
tumors have invaded other tissues, such as
the trachea, and can’t be treated with surgery.
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