Oesophageal Cancer — TNM

Name: Oesophageal Cancer — TNM calculator — MedScore
Creator: Nabil Alzein

AJCC 8th edition (2017), pathological (pTNM) — squamous cell carcinoma (with grade and location) or adenocarcinoma (with grade)

Histology

Squamous cell carcinoma

Adenocarcinoma

T — primary tumour

Tis — high-grade dysplasia

T1a — invades the lamina propria or muscularis mucosae

T1b — invades the submucosa

T2 — invades the muscularis propria

T3 — invades the adventitia

T4a — invades the pleura, pericardium, azygos vein, diaphragm or peritoneum

T4b — invades other adjacent structures (aorta, vertebral body, airway)

N — regional lymph nodes

N0 — no regional lymph node metastasis

N1 — metastasis in 1–2 regional lymph nodes

N2 — metastasis in 3–6 regional lymph nodes

N3 — metastasis in 7 or more regional lymph nodes

M — distant metastasis

M0 — no distant metastasis

M1 — distant metastasis

G — histological grade

G1 — well differentiated

G2 — moderately differentiated

G3 — poorly differentiated or undifferentiated

GX — grade cannot be assessed

Tumour location (by the tumour epicentre; squamous cell carcinoma only)

Upper — cervical oesophagus to the lower border of the azygos vein

Middle — lower border of the azygos vein to the lower border of the inferior pulmonary vein

Lower — lower border of the inferior pulmonary vein to the stomach, including the gastro-oesophageal junction

Location unknown

About this score

When to use

Assigns the AJCC 8th-edition pathological stage (pTNM) of oesophageal and oesophagogastric junction cancer. ⁦[1]⁩

Pearls and pitfalls

• There are separate clinical (cTNM), pathological (pTNM) and post-neoadjuvant (ypTNM) tables; this tool uses pTNM. ⁦[1]⁩

• Squamous cell carcinoma is staged with grade and tumour location, adenocarcinoma with grade. ⁦[2]⁩

Summarised from the numbered sources under Evidence. Check the source before relying on a statement.

Evidence

[1] Original publication

Amin MB, Edge SB, Greene FL, et al., eds. AJCC Cancer Staging Manual, 8th edition. New York: Springer; 2017. Oesophagus and oesophagogastric junction: separate clinical (cTNM), pathological (pTNM) and post-neoadjuvant (ypTNM) tables; this tool uses pTNM. Confirm against the manual.

Springer, 2017

[2] Guideline

PDQ® Adult Treatment Editorial Board. Esophageal Cancer Treatment (PDQ®) – Health Professional Version. National Cancer Institute — reprints the AJCC 8th-edition pTNM tables for squamous cell carcinoma (with grade and tumour location) and adenocarcinoma (with grade). Where a lower-third T3 N0 SCC has grade GX, the table matches both "lower, any grade → IIA" and "GX, any location → IIB"; this tool applies the location-specific row (IIA).

Open source

Last reviewed: 2026-10

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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.