Stage 2 oesophageal cancer

What is stage 2 oesophageal cancer?

Staging 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) 

For some stage 2 squamous cell oesophageal cancers, the doctor also considers where the cancer is in your oesophagus.

Your oesophagus has 3 parts – the upper, middle and lower part.

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. 

Read more about how doctors stage oesophageal cancer

Staging systems

Doctors use different systems to stage oesophageal cancer. This page is about stage 2 cancer, which is part of the number staging system. This system has 5 stages, stage 0 (high grade dysplasia) to stage 4.

This page also tells you what stage 2 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)

Find out about the TNM staging system for oesophageal cancer

Squamous cell cancer

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

Clinical staging and pathological staging

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 2 squamous cell cancer (clinical stage)

Stage 2 squamous cell cancer (clinical stage) can be any grade and anywhere in the oesophagus.

The cancer has grown into the thick muscle wall or outer layer (adventitia) of the oesophagus. It might have spread to 1 or 2 nearby lymph nodes.

In TNM staging, stage 2 includes:

• T2, N0 or N1, M0

•  T3, N0, M0

Stage 2 squamous cell (pathological stage)

Stage 2 squamous cell (pathological stage) depends on the grade of your cancer and where it is in the oesophagus.

It’s split into 2 groups - 2A and 2B.

Stage 2A

Stage 2A means the cancer has grown into the thick muscle wall or outer layer (adventitia) of your oesophagus. It hasn’t spread to nearby lymph nodes.

In TNM staging stage 2A means:

• T2 or T3, N0, M0.

Stage 2B

Stage 2B means the cancer has grown into either the supportive tissue (submucosa) or outer layer of your oesophagus. It might have spread to 1 or 2 nearby lymph nodes.

In TNM staging, stage 2B can include:

• T3, N0, M0

• T1, N1, M0.

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 2 adenocarcinoma (clinical stage)

Stage 2 adenocarcinoma (clinical stage) is in any part of the oesophagus and is any grade.

It’s split into 2 groups - 2A and 2B.

Stage 2A

Stage 2A means the cancer has grown no further than the supportive tissue (submucosa). But it has spread to 1 or 2 nearby lymph nodes.

In TNM staging, stage 2A is:

• T1, N1, M0

Stage 2B

Stage 2B means the cancer has grown into the thick muscle wall of the oesophagus. It hasn't spread to any lymph nodes. 

In TNM staging, stage 2B is:

• T2, N0, M0.

Stage 2 adenocarcinoma (pathological stage)

Stage 2 adenocarcinoma (pathological stage) is in any part of the oesophagus. It depends on the grade of your cancer.

It’s split into 2 groups - 2A and 2B.

Stage 2A

Stage 2A means the cancer has grown into the thick muscle wall. It has not spread to nearby lymph nodes.

In TNM staging stage 2A means:

• T2, N0, M0

Stage 2B

Stage 2B means the cancer has grown into either the supportive tissue (submucosa) or outer layer (adventitia) of your oesophagus. It might have spread to 1 or 2 nearby lymph nodes.

In TNM staging, stage 2B includes:

• T3, N0, M0.

• T1, N1, M0.

Treatment for stage 2 oesophageal cancer

Your treatment depends on whether you have squamous cell cancer or adenocarcinoma. Most people who have surgery will have treatment before the surgery (neoadjuvant treatment).

For squamous cell cancer you usually have chemoradiotherapy. And then you either have:

• surgery to remove part or all of your oesophagus

• no further treatment and the doctors keep a close eye on you - this is called active surveillance

For adenocarcinoma you either have:

• chemotherapy before surgery

• chemotherapy before and after surgery

• chemoradiotherapy before surgery

Some people might have immunotherapy treatment if there are any cancer cells left after surgery.

Read about the different treatments for oesophageal cancer

About other stages

• High grade dysplasia

• Stage 1

• Stage 3

• Stage 4