NCCN Guidelines for Patients® | Esophageal Cancer - page 18

18
NCCN Guidelines for Patients
®
: Esophageal Cancer
Version 1.2013
Part 2: Cancer staging
2.4 Stages of esophageal cancer
Table 1 shows the staging groups labeled by Roman
numerals 0–IV. Stage 0 is also called HGD (
h
igh-
g
rade
d
ysplasia). The stages are defined by the TNM scores
and histologic grade. For squamous cell carcinoma,
staging also depends on where the tumor is in the
esophagus. The esophagus is evenly divided into three
sections:
• Upper – the part between the thoracic inlet and the
azygos vein,
• Middle – the part below the azygos vein and above
the inferior pulmonary veins, and
• Lower – the part below the inferior pulmonary veins.
In general, earlier cancer stages have better outcomes.
However, doctors define cancer stages with information
from thousands of patients, so a cancer stage gives an
average outcome. It may not tell the outcome for one
person. Some people will do better than expected. Others
will do worse. Other factors not used for staging cancer,
such as your general health, are also very important.
Table 1. Esophageal cancer stages
ANATOMIC STAGE/PROGNOSTIC GROUPS
Squamous cell carcinoma*
Stage T N M Grade Tumor Location
0
Tis
(HGD)
N0 M0 1, X Any
IA T1 N0 M0 1, X Any
IB T1 N0 M0 2–3 Any
T2–3 N0 M0 1, X Lower, X
IIA T2–3 N0 M0 1, X Upper, middle
T2–3 N0 M0 2–3 Lower, X
IIB T2–3 N0 M0 2–3 Upper, middle
T1–2 N1 M0 Any Any
IIIA T1–2 N2 M0 Any Any
T3 N1 M0 Any Any
T4a N0 M0 Any Any
IIIB T3 N2 M0 Any Any
IIIC T4a N1–2 M0 Any Any
T4b Any M0 Any Any
Any N3 M0 Any Any
IV Any Any M1 Any Any
*Or mixed histology including a squamous component
or NOS
1...,8,9,10,11,12,13,14,15,16,17 19,20,21,22,23,24,25,26,27,28,...100
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