S4.
Pathological TNM staging of adenocarcinoma of esophagus/esophagogastric junction (pTNM)
| Stage | TNM | Grade |
| 1. HGD, High-grade dysplasia.
2. Number of harvested regional lymph nodes should be more than 12 to achieve accurate staging. 3. Location (primary cancer site) is defined by position of the tumor epicenter (divided into upper, middle and lower esophagus. Upper esophagus = cervical esophagus + upper thoracic esophagus; middle esophagus = middle thoracic esophagus; lower esophagus = lower thoracic esophagus + abdominal esophagus). 4. Tumors with a midpoint in the lower thoracic esophagus, EGJ, or within the proximal 2 cm of the stomach that extends into the EGJ (Siewert types I and II) are classified as esophageal cancer for staging purposes; Tumors with a midpoint in the stomach more than 2 cm distal to the EGJ (Siewert type III) are staged using the gastric cancer staging system. 5. Basal cell-like squamous cell carcinoma, spindle cell squamous cell carcinoma, small cell carcinoma, large cell neuroendocrine carcinoma and undifferentiated carcinoma are staged as poorly differentiated squamous cell carcinoma. Mixed carcinoma with mixed squamous cell carcinoma components (e.g. adenosquamous carcinoma) or histologically unidentified carcinoma are staged as squamous cell carcinoma. 6. Neuroendocrine tumors (NET) of the esophagus are rare, and their staging is based on the TNM staging of gastrointestinal neuroendocrine tumors. 7. This stage is not suitable for non-epithelial tumors such as lymphoma, sarcoma, gastrointestinal stromal tumor and melanoma. | ||
| 0 | Tis (HGD) N0 M0 | |
| IA | T1a N0 M0 | G1 |
| IA | T1a N0 M0 | GX |
| Ib | T1a N0 M0 | G2 |
| T1b N0 M0 | G1−G2 | |
| T1b N0 M0 | GX | |
| IC | T1 N0 M0 | G3 |
| T2 N0 M0 | G1−G2 | |
| IIA | T2 N0 M0 | G3 |
| T2 N0 M0 | GX | |
| IIB | T1 N1 M0 | Any |
| T3 N0 M0 | Any | |
| IIIA | T1 N2 M0 | Any |
| T2 N1 M0 | Any | |
| IIIB | T2 N2 M0 | Any |
| T3 N1−2 M0 | Any | |
| T4a N0−1 M0 | Any | |
| IVA | T4a N2 M0 | Any |
| T4b N0−2 M0 | Any | |
| Any T N3 M0 | Any | |
| IVB | Any T Any N M1 | Any |