Thoracic Oncology Program

Esophageal Cancer

Stages of Esophageal Cancer

If a patient has cancer of the esophagus, the doctor will do more tests will be done to find out if the cancer cells have spread to other parts of the body. This is called staging. To plan treatment, a doctor needs to know the stage of the disease.

The three most important considerations in staging esophageal cancer are:

how deeply the tumor has penetrated the esophagus
whether any local lymph nodes are involved
whether the disease has spread beyond the esophagus or local lymph nodes

The following stages are used for cancer of the esophagus:

Stage 0 or carcinoma in situ - Stage 0 cancer of the esophagus is very early cancer. Cancer is found only in the first layer of cells in the lining of the esophagus. Treatment is usually surgery to remove the tumor.

Stage I - Cancer has only penetrated a small distance into the wall of the esophagus and has not spread to nearby tissues, lymph nodes, or other organs. (Lymph nodes are small, bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells.) Treatment may be one of the following:

Surgery to remove the tumor and all or part of the esophagus (esophagectomy).
Chemotherapy plus radiation therapy. Surgery may be performed after other therapy is completed. (Clinical trials currently are testing changes in the timing of when chemotherapy and radiation therapy are given.)
Photodynamic Therapy for high risk patients.

Stage II - Cancer has penetrated more deeply into the wall of the esophagus or may have spread to local lymph nodes, but has not spread to other tissues. Treatment may be one of the following:

Surgery to remove the tumor and all or part of the esophagus (esophagectomy).
Chemotherapy plus radiation therapy. Clinical trials are testing changes in the timing of when chemotherapy and radiation therapy are given.
Clinical trials of chemotherapy and radiation therapy with surgery.

Stage III - Cancer has spread to tissues or lymph nodes near the esophagus, but has not spread to other parts of the body. Treatment may be one of the following:

Surgery to remove the tumor to relieve pain or discomfort.
Chemotherapy plus radiation therapy. Surgery may be performed after other therapy is completed.
Clinical trials of chemotherapy plus radiation therapy.

Stage IV - Cancer has spread to other parts of the body. Treatment may be one of the following:

Radiation therapy with or without insertion of a tube to keep the esophagus open (intraluminal intubation and dilation).
Tumor removal by laser or electrical current.
Clinical trials of chemotherapy plus radiation therapy.

Recurrent - Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the esophagus or in another part of the body. Treatment may include surgery or radiation therapy to relieve pain or discomfort. A patient may choose to take part in a clinical trial.

This page was last updated on: March 3, 2008.