Esophageal Cancer

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Esophageal Cancer Stages

The treatment that your doctors recommend for esophageal cancer will be based, in part, on the stage of your cancer. The stage depends on:

  • How far the cancer has spread through the wall of your esophagus
  • Whether the cancer has spread to nearby lymph nodes
  • Whether the cancer has spread to other parts of your body

There are different staging systems for adenocarcinoma and squamous cell carcinoma of the esophagus. Both systems use Roman numerals I, II, III, and IV, with stage I being the least advanced and stage IV being the most advanced stage.

Adenocarcinoma of the Esophagus

Stage I

  • Stage IA: Cancer has formed in the innermost layer (mucosa) of the esophageal wall. The cancer cells look much like normal cells.
  • Stage IB: Cancer has formed in the innermost layer of the esophageal wall, the cancer cells do not look like normal cells, and the cancer cells grow quickly; OR cancer has formed in the innermost layer and spread to the middle layer (muscle) of the esophageal wall, and the cancer cells look much like normal cells.

Stage II

  • Stage IIA: Cancer has spread to the middle layer of the esophageal wall, the cancer cells do not look like normal cells, and the cancer cells grow quickly.
  • Stage IIB: Cancer has spread to the outermost layer of the esophageal wall, OR cancer is in the innermost layer of the esophageal wall, it may have spread into the middle layer, and it’s found in one or two lymph nodes nearby.

Stage III

  • Stage IIIA: Cancer is in the innermost layer of the esophageal wall, it may have spread into the middle layer, and it’s found in three to six lymph nodes nearby; OR cancer has spread to the outermost layer of the esophageal wall, and it’s found in one or two lymph nodes nearby; OR cancer has spread to the diaphragm, the sac around the heart, or the tissue that covers the lungs and lines the chest cavity, and it can be removed surgically.
  • Stage IIIB: Cancer has spread to the outermost layer of the esophageal wall, and it’s found in three to six lymph nodes nearby.
  • Stage IIIC: Cancer has spread into the diaphragm, the sac around the heart (pericardium), or the tissue that covers the lungs and lines the chest cavity, it can be removed surgically, and it’s found in one to six lymph nodes nearby; OR cancer has spread to other nearby organs (such as the spine or trachea), and it cannot be removed surgically; OR cancer has spread to seven or more lymph nodes nearby.

Stage IV

Cancer has spread to other parts of your body.

Squamous Cell Carcinoma of the Esophagus

Stage I

  • Stage IA: Cancer has formed in the innermost layer (mucosa) of the esophageal wall. The cancer cells look much like normal cells.
  • Stage IB: Cancer has formed in the innermost layer of the esophageal wall, and the cancer cells do not look like normal cells; OR cancer has formed in the innermost layer and spread to the middle layer (muscle) or outermost layer (connective tissue) of the esophageal wall, the cancer cells look much like normal cells, and the tumor is in the lower part of the esophagus or its location is not known.

Stage II

  • Stage IIA: Cancer has spread to the middle layer or outermost layer of the esophageal wall, the cancer cells look much like normal cells, and the tumor is in the upper or middle part of the esophagus; OR cancer has spread to the middle layer or outermost layer of the esophageal wall, the cancer cells do not look like normal cells, and the tumor is in the lower part of the esophagus or its location is not known.
  • Stage IIB: Cancer has spread to the middle layer or outermost layer of the esophageal wall, the cancer cells do not look like normal cells, and the tumor is in the upper or middle part of the esophagus; OR cancer is in the innermost layer of the esophageal wall, it may have spread into the middle layer, and it’s found in one or two lymph nodes nearby.

Stage III

  • Stage IIIA: Cancer is in the innermost layer of the esophageal wall, it may have spread into the middle layer, and it’s found in three to six lymph nodes nearby; OR cancer has spread to the outermost layer of the esophageal wall, and it’s found in one or two lymph nodes nearby; OR cancer has spread to the diaphragm, the sac around the heart, or the tissue that covers the lungs and lines the chest cavity, and it can be removed surgically.
  • Stage IIIB: Cancer has spread to the outermost layer of the esophageal wall, and it’s found in three to six lymph nodes nearby.
  • Stage IIIC: Cancer has spread into the diaphragm, the sac around the heart, or the tissue that covers the lungs and lines the chest cavity, it can be removed surgically, and it’s found in one to six lymph nodes nearby; OR cancer has spread to other nearby organs (such as the spine or trachea), and it cannot be removed surgically; OR cancer has spread to seven or more lymph nodes nearby.

Stage IV

Cancer has spread to other parts of your body.