Esophageal Cancer Staging

The "T" stage is as follows:
Tis-carcinoma in situ

T1-tumor confined to the inner layer of the esophageal wall (submucosa or lamina propria)

T2-tumor invades into the muscular layer of the wal
l
T3-tumor invades into the outer layer of the wall (adventitia)

T4-tumor invades into other structures or organs

The "N" stage is as follows for any subsite:
N0-no spread to lymph nodes

N1-tumor spread to regional lymph nodes

-lymph nodes outside the chest are considered "M1"
The "M" stage is as follows:

M0-no tumor spread to other organs

M1-tumor spread to other organs

This is also broken down by site of the primary tumor within the esophagus:

Tumors of the lower esophagus:

M1a-cancer spread to the lymph nodes in the abdomen (called celiac nodes).

M1b-cancer has spread to other parts of the body.

Tumors of the upper esophagus:

M1a-cancer spread to the lymph nodes in the neck (called cervical or supraclavicular nodes).

M1b-cancer has spread to other parts of the body.

The overall stage is based on a combination of these T, N, and M parameters:
Stage 0: Cancer in situ.

Stage I: Cancer in the two inside layers of the esophagus (T1N0M0)

Stage IIA: Cancer in any of the four layers of the esophagus (T2-3N0M0)

Stage IIB: Cancer in any layer of the esophagus, with spread to lymph nodes near the
tumor (T1-2N1M0)

Stage III: Cancer is in the outside layer of the esophagus, or through the wall. Cancer is
also in the lymph nodes (T3-4N1M0)

Stage IVA: Cancer spread to the lymph nodes of the abdomen or neck (T1-4N0-1M1a)

Stage IVB: Cancer has spread to other parts of the body (T1-4N0-1M1b)