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18

NCCN Guidelines for Patients

®

Esophageal Cancer, Version 1.2016

The 5 stages

Chart 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 cancer 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.

2

Cancer staging

The 5 stages

Chart 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