What are the recent changes to esophageal cancer staging?
• Staging applies to masses that arise within the first 5 cm of the stomach that extend into the esophagus.
• T4 is divided into T4a, in which the tumor invades the pleura, pericardium, or diaphragm and is potentially resectable, whereas T4b tumors are unresectable with invasion into other adjacent structures, including the aorta, vertebral body, and trachea.
• Regional nodal staging is no longer binary, but classified as N0 through N3: N0 with no lymph node (LNs), N1 with one or two LNs, N2 with three to six LNs, and N3 with seven or more LNs.
• Regional lymphadenopathy includes LNs in the chest, around the esophagus, and celiac axis.
• Celiac axis lymphadenopathy no longer qualifies as metastatic disease.