Stages, types and grades of oesophageal cancer
The stage of a cancer tells you how big it is and how far it has spread. It helps your doctor decide which treatment you need.
Tumour, node and metastasis (TNM) staging is the most common way to stage oesophageal cancer.
Doctors may also use a number staging system. There are 5 main stages - stage 0 (high grade dysplasia) to stage 4.
Find out about the number staging system
Tumour describes the size of the tumour (area of cancer). This is a simplified description of the T stage.
There are 4 stages of tumour size in oesophageal cancer - T1 to T4.
T1 means the cancer has grown no further than the layer of supportive tissue (submucosa). It's split into 2 further stages, T1a and T1b:
T1a means the cancer is in the inner layer (mucosa) or thin muscle layer of the oesophagus wall
T1b means the cancer has grown into the supportive tissue (submucosa)
T2 means the cancer has grown into the thick muscle wall of the oesophagus.
T3 means the tumour has grown into the membrane covering the outside of the oesophagus (adventitia).
T4 means the tumour has grown into other organs or body structures next to the food pipe. It’s divided into T4a and T4b:
T4a means the cancer has grown into the tissue covering the lungs (pleura), the outer covering of the heart (pericardium), the muscle at the bottom of the rib cage (diaphragm), or the tissue lining the abdomen (peritoneum)
T4b means that the cancer has spread into other nearby structures such as the windpipe (trachea), a spinal bone (vertebra) or a major blood vessel (the aorta).
Node (N) describes whether the cancer has spread to the lymph nodes.
There are 4 possible stages describing whether the lymph nodes contain cancer - N0 to N3.
N0 means there are no lymph nodes containing cancer cells.
N1 means there are cancer cells in 1 or 2 nearby lymph nodes.
N2 means there are cancer cells in 3 to 6 nearby lymph nodes.
N3 means there are cancer cells in 7 or more nearby lymph nodes.
Metastasis (M) describes whether the cancer has spread to a different part of the body.
There are 2 stages of metastasis.
M0 means the cancer has not spread to other organs.
M1 means the cancer has spread to other parts of the body.
The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
your type of cancer (the type of cells the cancer started in)
where the cancer is
other health conditions that you have
The stage of the cancer and these other factors can also give an idea of your outlook (prognosis).
Treatment might include:
surgery - to remove part or all your oesophagus
chemotherapy
radiotherapy
chemoradiotherapy (chemotherapy together with radiotherapy)
targeted or immunotherapy cancer drugs
symptom control treatment
You may have treatment as part of a clinical trial.
Last reviewed: 17 Aug 2023
Next review due: 17 Aug 2026
Survival depends on many factors including the stage and type of your oesophageal cancer.
You might have surgery, radiotherapy or chemotherapy or a combination of these treatments. This depends on a number of factors including the stage and type of your oesophageal cancer.
Oesophageal cancer is a cancer of the food pipe. The food pipe is also called the oesophagus or gullet and is part of the digestive system.
There is support available to help you cope during and after oesophageal cancer treatment. This includes diet tips to help you eat well.
The stage of a cancer tells you how big it is and whether it has spread. It helps your doctor to know which treatment you need.
Oesophageal cancer starts in the food pipe, also known as your oesophagus or gullet. The oesophagus is the tube that carries food from your mouth to your stomach.
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