How is esophageal cancer staged?

Written by Liu Liang
Oncology
Updated on February 16, 2025
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The staging of esophageal cancer includes a preoperative clinical staging and a postoperative pathological staging. Clinical staging involves completing various systemic examinations, determining the extent of the tumor, whether there are lymph node metastases, and whether there are distant metastases to organs such as the liver and lungs. This requires thorough assessments, including esophageal endoscopic ultrasound and whole-body examinations like PET-CT, to conduct clinical staging. Postoperative pathological staging, on the other hand, is determined based on the depth of tumor invasion reached during surgery and the status of lymph node metastasis, among other factors.

Other Voices

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Written by Si Li Li
Gastroenterology
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The difference between esophagitis and esophageal cancer.

Esophagitis and esophageal cancer can be differentiated in the following aspects. First, in terms of symptoms, esophagitis generally presents with symptoms such as acid reflux, heartburn, pain behind the sternum, belching, and upper abdominal pain. The main symptoms of esophageal cancer, on the other hand, are generally difficulty swallowing or pain when swallowing, and this symptom progressively worsens. Second, regarding age, esophagitis can occur in any age group, while esophageal cancer is more common in elderly male patients. Third, the best method of differentiation is through gastroscopy. Under gastroscopy, esophagitis can be diagnosed with findings such as mucosal erosion, congestion, and edema of the esophagus. Esophageal cancer, however, generally appears in the middle or upper or lower segments of the esophagus, and a diagnosis can be confirmed by performing a biopsy.

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Written by Gong Chun
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What should I do about esophageal cancer?

Currently, effective treatments for esophageal cancer include surgical treatment, radiation therapy, and chemotherapy. Integrated treatment with surgery as the main approach is the primary method for treating esophageal cancer. This may include preoperative radiotherapy followed by surgery, preoperative chemoradiotherapy followed by surgery, preoperative chemotherapy followed by surgery, or direct surgery followed by adjuvant chemoradiotherapy. These are all major treatment methods for esophageal cancer. However, the choice of a personalized integrated treatment should be based on factors such as the stage of the disease, the location of the lesion, age, and physical condition.

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Written by Liu Liang
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Esophageal cancer metastasis pathways

"In terms of the metastatic pathways of esophageal cancer, the first one is through the bloodstream, known as hematogenous spread. This primarily results in metastases to distant organs such as the lungs, liver, bones, etc. The second pathway is via the lymphatic system. Lymphatic spread leads to metastases in regional lymph nodes and distant lymph nodes. The third pathway is through local invasion by the tumor, where the esophageal cancer can invade nearby organs and spread. These are the pathways through which metastasis occurs."

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Written by Zhai Guo Dong
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The difference between esophagitis and esophageal cancer.

Esophagitis and esophageal cancer have essential differences. Esophagitis is merely an inflammatory disease, which is relatively common in clinical settings and often related to excessive stomach acid, acid reflux, or other physical and chemical irritants. Esophageal cancer, on the other hand, is a malignant tumor. The mechanisms of their development, as well as the differences in prognosis and treatment plans, are very significant.

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The main metastatic pathways of esophageal cancer

The main metastatic pathways of esophageal cancer include firstly, hematogenous spread, which can transfer to distant organs such as bones and the lungs or liver via the bloodstream. The second pathway is via the lymphatic system, which can lead to the metastasis of regional lymph nodes and other non-regional lymph nodes. For example, cervical esophageal cancer tends to metastasize to the supraclavicular and adjacent esophageal lymph nodes; in thoracic esophageal cancer, metastases may occur in the subcarinal, upper periesophageal, and lower periesophageal lymph nodes; metastasis can also be achieved through local spread and invasion of the tumor.