Stage 3

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

What is stage 3 oesophageal cancer?

Stage 3 oesophageal cancer might have spread beyond the outer layer of the oesophagus into nearby tissue - for example, the covering of the lungs (pleura), the outer covering of the heart (pericardium) or the muscle at the bottom of the rib cage (diaphragm).

The cancer might also have spread to up to 6 nearby lymph nodes. But there is no sign of it spreading to any distant body parts. 

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) 

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 3 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 3 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 3 squamous cell cancer (clinical stage) can be any grade.

It means the cancer has grown no further than the outer layer of the oesophagus wall and is in up to 6 nearby lymph nodes.

In TNM staging, stage 3 is:

  • T1, T2 or T3, N1 or N2, M0
Diagram showing stage 3 squamous cell oesophageal cancer (clinical stage)

Stage 3 squamous cell cancer (pathological stage) can be any grade.

It’s split into 2 stages - stage 3A and stage 3B. 

Stage 3A means the cancer might have grown into the supportive or thick muscle layer of the oesophagus. It might be in up to 6 nearby lymph nodes.  

In TNM staging, stage 3A includes:

  • T1, N2, M0
Diagram showing stage 3A oesophageal cancer (pathological stage) 1 of 2
  • T2, N1, M0.
Diagram showing stage 3A oesophageal cancer (pathological-stage) 2 of 2

Stage 3B means the cancer has spread into the thick muscle or outer layer or the oesophagus. Or it has spread into nearby tissue such as the tissue covering the lungs (pleura), the outer covering of the heart (pericardium) or the muscle at the bottom of the rib cage (diaphragm).  

It might have spread into up to 6 lymph nodes. 

In TNM staging, stage 3B includes:

  • T2, N2, M0
Diagram showing stage 3B oesophageal cancer (pathological stage) 1 of 3
  • T3, N1 or N2, M0.
Diagram showing stage 3B oesophageal cancer (pathological stage) 2 of 3
  • T4a, N0 or N1, M0.
Diagram showing stage 3B oesophageal cancer (pathological stage) 3 of 3

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 3 adenocarcinoma (clinical stage) can be any grade.

It means the cancer has spread into the thick muscle or outer layer or the oesophagus. Or it has spread into nearby tissue such as the tissue covering the lungs (pleura), the outer covering of the heart (pericardium) or the muscle at the bottom of the rib cage (diaphragm). 

It might have spread into 1 or 2 lymph nodes. 

In TNM staging, stage 3 includes:

  • T2, N1, M0
Diagram showing stage 3 oesophageal adenocarcinoma (clinical stage) 1 of 3
  • T3, N0 or N1, M0
Diagram showing stage 3 oesophageal adenocarcinoma (clinical stage) 2 of 3
  • T4a, N0 or N1, M0
Diagram showing stage 3 oesophageal adenocarcinoma (clinical stage) 3 of 3

Stage 3 adenocarcinoma (pathological stage) can be any grade.

It’s split into 2 stages - stage 3A and stage 3B. 

Stage 3A means the cancer might have grown into the supportive or thick muscle layer of the oesophagus. It might be in up to 6 nearby lymph nodes.  

In TNM staging, stage 3A includes:

  • T1, N2, M0
Diagram showing stage 3A oesophageal cancer (pathological stage) 1 of 2
  • T2, N1, M0
Diagram showing stage 3A oesophageal cancer (pathological-stage) 2 of 2

Stage 3B means the cancer has spread into the thick muscle or outer layer or the oesophagus. Or it has spread into nearby tissue such as the tissue covering the lungs (pleura), the outer covering of the heart (pericardium) or the muscle at the bottom of the rib cage (diaphragm). 

It might be in up to 6 lymph nodes. 

In TNM staging, stage 3B can include:

  • T2, N2, M0
Diagram showing stage 3B oesophageal cancer (pathological stage) 1 of 3
  • T3, N1 or N2, M0
Diagram showing stage 3B oesophageal cancer (pathological stage) 2 of 3
  • T4a, N0 or N1, M0
Diagram showing stage 3B oesophageal cancer (pathological stage) 3 of 3

Treatment for stage 3 oesophageal cancer

Your treatment depends on whether you have squamous cell cancer or adenocarcinoma.

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

You might have chemoradiotherapy without surgery if you aren't well enough or choose not to have surgery.

About other stages

Last reviewed: 
11 Dec 2019
  • 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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