Stage 1

The stage of your cancer tells the doctor how far it has grown and if it has spread.

What is stage 1 oesophageal cancer?

Stage 1 oesophageal cancer usually means your cancer hasn’t spread beyond the thick muscle in the oesophagus wall.

It usually means your cancer hasn’t spread to nearby lymph nodes. But some people with stage 1 squamous cell cancer can have cancer in 1 or 2 nearby lymph nodes. 

Stage 1 cancer hasn’t spread to other body parts, structures or distant organs.

This is a simplified description. We have much more detailed information below on this page. 

Staging oesophageal cancer is very complicated. It depends on:

  • what type of oesophageal cancer you have (squamous cell or adenocarcinoma)
  • the grade of your cancer (how abnormal the cells look)
  • whether doctors stage your cancer using tests and scans (clinical staging) or after surgery (pathological staging) 

When you read the information on this page, it's helpful to know what type of oesophageal cancer you have and whether the doctor is using pathological or clinical staging. Talk to your specialist doctor or nurse if you are unsure. They can help you understand more about your cancer stage. 

You can call the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.

Staging systems

Doctors use different systems to stage oesophageal cancer. This page is about stage 1 cancer, which is part of the number staging system. This system has 5 stages, stage 0 to stage 4.

This page also tells you what stage 1 means in the TNM system. This system describes:

  • the size of the primary tumour (T)
  • whether the cancer has spread to the lymph nodes (N)
  • whether the cancer has spread to another part of the body (M)

Squamous cell cancer

Squamous cell cancers develop from squamous cells that make up the inner lining of your oesophagus.

Clinical staging means your doctor uses test and scan results to stage your cancer. This is different to pathological staging, which doctors use after surgery. 

Your doctor might tell you your clinical stage to begin with. And if you go on to have surgery, your stage might change when the doctor finds out your pathological stage.  

Stage 1 squamous cell cancer (clinical stage) can be any grade.

It means the cancer has grown no further than the layer of supportive tissue. But it might have spread to 1 or 2 nearby lymph nodes. It hasn’t spread to distant organs.

In TNM staging, stage 1 is:

  • T1, N0 or N1, M0
Diagram showing stage 1 squamous cell oesophageal cancer (clinical-stage)

Stage 1 squamous cell cancer (pathological stage) has not spread to nearby lymph nodes or distant organs.

It depends on the grade of your cancer.

It’s split into 2 groups - stage 1A and stage 1B. 

Stage 1A means the cancer has grown no further than the thin muscle layer of the oesophagus wall.

In TNM staging, stage 1A is:

  • T1a, N0, M0
Diagram showing stage 1A squamous cell oesophageal cancer (pathological-stage)

Stage 1B means the cancer has grown into the thin muscle, supportive layer or thick muscle layer of the oesophagus.

In TNM staging, stage 1B is:

  • T1a, T1b or T2, N0, M0
Diagram showing stage 1B squamous cell oesophageal cancer (pathological-stage)

Adenocarcinoma

Adenocarcinomas are cancers that develop in gland cells. These cells make mucus in the lining of the oesophagus.

Clinical staging means your doctor uses test and scan results to stage your cancer. This is different to pathological staging, which doctors use after surgery. 

Your doctor might tell you your clinical stage to begin with. And if you go on to have surgery, your stage might change when the doctor finds out your pathological stage.  

Stage 1 adenocarcinoma (clinical stage) can be any grade.

It means the cancer has grown no further than the supportive tissue layer. It has not spread into lymph nodes or distant organs.

In TNM staging, stage 1 is:

  • T1, N0, M0
Diagram showing stage 1 oesophageal adenocarcinoma (clinical-stage)

Stage 1 adenocarcinoma (pathological stage) has not spread to nearby lymph nodes or distant organs.

It depends on the grade of your cancer.

It’s split into 3 stages - stage 1A, stage 1B and stage 1C. 

Stage 1A means the cancer has grown no further than the thin muscle layer of the oesophagus wall.

In TNM staging, stage 1A is:

  • T1a, N0, M0
Diagram showing stage 1A oesophageal adenocarcinoma (pathological-stage)

Stage 1B means the cancer has grown no further than the supportive layer of the oesophagus.

In TNM staging, stage 1B is:

  • T1a or T1b, N0, M0
Diagram showing stage 1B oesophageal adenocarcinoma (pathological-stage)

Stage 1C means the cancer has grown into the supportive or thick muscle layer of the oesophageal wall.

In TNM staging stage 1C is:

  • T1 or T2, N0, M0
Diagram showing stage 1C oesophageal adenocarcinoma (pathological-stage)

Treatment for stage 1 oesophageal cancer

Surgery is the main treatment. You don't usually need any other treatment before or after your operation. 

You have surgery to remove part or all of your oesophagus. This is called an oesophagectomy.

For very early, small stage cancers you might be able to have surgery through a thin flexible tube (endoscope) to remove cancer from the lining of the oesophagus. This is called an endoscopic mucosal resection or EMR.

You might have chemoradiotherapy instead of surgery if you have squamous cell cancer or you are unable to have surgery. 

About other stages

Last reviewed: 
27 May 2020
Next review due: 
26 May 2023
  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer, Springer, 2017

  • Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    F. Lordick and others
    Ann Oncol. 2016 27 Suppl 6: v50-v57

  • Oesophago-gastric cancer: assessment and management in adults  [NG83]
    National Institute for Health and Clinical Excellence (NICE)
    Published January 2018

  • Current management of oesophageal cancer
    N Rashid and others
    British Journal of Medical practitioners 2015 Volume 8, Issue 1, page 804

  • Oesophageal cancer
    E.C.Smith and others
    Nature Reviews Disease Primers Volume 3: 17048 (2018)

  • Oesophageal cancer
    J Lagergren and others
    The Lancet Vol 390, November 25th 2017

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