Esophageal Cancer: Classification

TNM classification of esophageal carcinomas and included carcinomas of the esophagogastric junction.

T Infiltration depth of the tumor
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis Carcinoma in situ
T1a Infiltration of the lamina propria
T1b Infiltration of the submucosa
T2 Infiltration of the muscularis propria
T3 Infiltration of the Adventitia
T4 Infiltration of neighboring structures
T4a Tumor infiltrates pleura (lung pleura), pericardium (heart pleura), diaphragm
T4b Tumor infiltrates other adjacent structures such as aorta, vertebral body, or trachea (windpipe)
N Lymph node metastases (daughter tumors in the lymph nodes)
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastases
N1 Metastases in 1-2 lymph nodes
N2 Metastases in 3-6 lymph nodes
N3 Metastases in 7 or more regional lymph nodes
M Metastases
M0 No metastases
M1 Distant metastases

pTNM: Pathological classification (The pT and pN categories correspond to the T and N categories).

  • PM1 – distant metastases
  • PN0 – Regional lymphadenectomy (lymph node removal) and histologic (fine tissue) examination usually of 7 or more lymph nodes.

Note: pM0 and pMX are not applicable categories.

TNM classification for staging.

Stage T N M
0 Tis N0 M0
IA T1 N0 M0
IB T2 N0 M0
IIA T3 N0 M0
IIB T1, T2 N1 M0
IIIA T4a N0 M0
T3 N1 M0
T1, T2 N2 M0
IIIB T3 N2 M0
IIIC T4a N1, N2 M0
T4b each N M0
each T N3 M0
IV T1-4 each N M1

Tumor regression score for adenocarcinomas according to Becker et al.

Regression score Definition
1a complete regression
1b Subtotal regression (1-50% residual tumor/ tumor bed).
2 Partial regression (10-50% residual tumor/ tumor bed).
3 Low/no regression (>50% residual tumor/ tumor bed).