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15

NCCN Guidelines for Patients

®

Esophageal Cancer, Version 1.2016

2

Cancer staging

TNM scores

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 nearby structures.

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..

o

T1a tumors have invaded the lamina

propria or muscularis mucosae.

o

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.

See

Figure 4

.

o

T4a

tumors have invaded the

outer lining of the lungs (pleura),

heart (pericardium), or abdomen

(peritoneum), or the diaphragm and

can be treated by surgery.

o

T4b

tumors tumors have invaded

tissues, such as the trachea, that

can’t be treated with surgery.

Figure 4.

Areas of T4 growth

The primary tumor may grow

through the esophageal wall

and into nearby organs. Nearby

structures include the windpipe

(trachea), lining of the lungs, left

bronchus, diaphragm, spine, lining

of the heart, aorta and other blood

vessels. Tumors that have grown

into nearby structures are rated T4.

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trachea

lung

aorta

bronchus

heart

diaphragm