Stage 2

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

What is stage 2 oesophageal cancer?

Stage 2 oesophageal cancer means your cancer might have spread as far as the outer layer covering your oesophagus.

Some stage 2 cancers have also spread into 1 or 2 nearby lymph nodes. But the 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 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 cancers, doctors also consider whereabouts the cancer is in your oesophagus. 

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 2 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 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)

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

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

In TNM staging, stage 2 includes:

  • T2, N0 or N1, M0
Diagram showing stage 2 squamous cell oesophageal cancer (clinical-stage) 1 of 2
  •  T3, N0, M0
Diagram showing stage 2 squamous cell oesophageal cancer (clinical stage) 2 of 2

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 means the cancer has grown into the thick muscle or outer layer of your oesophagus. It hasn’t spread to nearby lymph nodes.

In TNM staging stage 2A means:

  • T2 or T3, N0, M0.
Diagram showing stage 2A squamous cell oesophageal cancer (pathological stage)

Stage 2B means the cancer has grown into either the supportive layer 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
Diagram showing stage 2B squamous cell oesophageal cancer (pathological stage) 1 of 2
  • T1, N1, M0.
Diagram showing stage 2B squamous cell oesophageal cancer (pathological-stage) 2 of 2

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) is in any part of the oesophagus and is any grade.

It’s split into 2 groups - 2A and 2B.

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

In TNM staging, stage 2A is:

  • T1, N1, M0
Diagram showing stage 2A oesophageal adenocarcinoma (clinical-stage)

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

In TNM staging, stage 2B is:

  • T2, N0, M0.
Diagram showing stage 2B oesophageal adenocarcinoma (clinical-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 means the cancer has grown into the thick muscle layer. It has not spread to nearby lymph nodes.

In TNM staging stage 2A means:

  • T2, N0, M0
Diagram showing stage 2A oesophageal adenocarcinoma (pathological-stage)

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

In TNM staging, stage 2B includes:

  • T3, N0, M0.
Diagram showing stage 2B oesophageal adenocarcinoma (pathological-stage) 1 of 2
  • T1, N1, M0.
Diagram showing stage 2B oesophageal adenocarcinoma (pathological-stage) 2 of 2

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

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

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

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

  • 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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