Esophagus

Primary Site Histology Staging Type
C150-C155, C158-C159 8000-8576, 8940-8950, 8980-8981 TNM 7 and Summary Stage
C150-C155, C158-C159 8577-8934, 8951-8979, 8982-9136, 9141-9582, 9700-9701 Summary Stage only

If you are working with a site/histology that only summary stages and you need to directly code it, please use the SEER Summary Stage 2000 manual

Notes

C150 Cervical esophagus C151 Thoracic esophagus C152 Abdominal esophagus C153 Upper third of esophagus C154 Middle third of esophagus C155 Lower third of esophagus C158 Overlapping lesion of esophagus C159 Esophagus, NOS **Note 1:** This schema is based on the UICC chapter *Oesophagus including Oesophagogastric Junction,* pages 66-72. * Primary sites C151, C152, C158, and C159 are listed in the chapter heading but are not specified in the anatomic subsites in this chapter of the UICC manual; however, they are included in this schema and TNM staged if appropriate histology criteria are met **Note 2:** The cardia/gastroesophageal junction (EGJ), and the proximal 5 centimeters (cm) of the fundus and body of the stomach (C160-C162) have been removed from the Stomach chapter and added to the Esophagus chapter effective with TNM 7th Edition. A new schema EsophagusGEJunction, was created to accomodate this change. Tumors arising at the EGJ, or arising in the stomach within 5 cm of the EGJ and crossing the EGJ are staged using the Esophagus GE Junction schema. All other cancers with a midpoint in the stomach lying more than 5 cm distal to the EGJ, or those within 5 cm of the EGJ but not extending into the EGJ or esophagus, are staged using the stomach schema. **Note 3:** There are two widely used but incompatible systems of dividing the esophagus into subsites, one using anatomic landmarks and the other using using thirds of the total length. Each of these two systems has been assigned topography codes in ICD-O-3; codes C150-C152 for the former, and C153-C155 for the latter. * As explained on page 23 of ICD-O-3, "The terms cervical, thoracic, and abdominal are radiographic and intraoperative descriptors; upper, middle, and lower third are endoscopic and clinical descriptors" * In actual practice by physicians, the terms and codes for the upper, middle, and lower thirds are often applied to sub-sections of the thoracic esophagus, and the abdominal portion can be classified as part of the lower thoracic esophagus **Note 4:** Anatomic Limits of Esophagus * Cervical Esophagus (C150): From the lower border of the cricoid cartilage to the thoracic inlet (suprasternal notch), about 18 cm from the incisors. * Thoracic Esophagus (C151) and Abdominal Esophagus (C152) * Upper thoracic portion (C153): From the thoracic inlet to the level of the tracheal bifurcation (18-24 cm) * Mid-thoracic portion (C154): From the tracheal bifurcation midway to the EGJ (24-32 cm) * Lower thoracic portion (C155): From midway between the tracheal bifurcation and the EGJ to the EGJ including the abdominal esophagus (32-40 cm) **Note 5:** Effective with TNM 7th Edition * Histologic grade is required for stage grouping * There are separate stage groupings for squamous cell carcinoma and adenocarcinoma. Since squamous cell carcinoma typically has a poorer prognosis than adenocarcinoma, a tumor of mixed histopathologic type or a type that is not otherwise specified should be classified as squamous cell carcinoma **Note 6:** In addition to directly assigning TNM, Summary Stage 2000 (SS2000) must be captured. If directly assigning SS2000, use the *Esophagus* chapter on page 74 of the [SS2000 on-line manual](http://seer.cancer.gov/tools/ssm/SSSM2000-122012.pdf#page=74).

Main Data Items

Name Default Value Used for Staging NAACCR Item Required By Metadata
Grade <BLANK> Yes NAACCR #440 None
Clinical T <BLANK> Yes NAACCR #940 None
Clinical N <BLANK> Yes NAACCR #950 None
Clinical M <BLANK> Yes NAACCR #960 None
TNM Clin Stage Group 99 Yes NAACCR #970 None
Pathologic T <BLANK> Yes NAACCR #880 None
Pathologic N <BLANK> Yes NAACCR #890 None
Pathologic M <BLANK> Yes NAACCR #900 None
TNM Path Stage Group 99 Yes NAACCR #910 None
SSF2: Specific Location of Tumor 988 No NAACCR #2890 None None
SSF3: Number of Regional Lymph Nodes with Extracapsular Tumor 988 No NAACCR #2900 None None
SSF4: Distance to Proximal Edge of Tumor from Incisors 988 No NAACCR #2910 None None
SSF5: Distance to Distal Edge of Tumor from Incisors 988 No NAACCR #2920 None None

Additional Data Items

Name Default Value Used for Staging NAACCR Item Required By Metadata
Year of Diagnosis <BLANK> No NAACCR #390 None
Primary Site <BLANK> Yes NAACCR #400 None
Histology <BLANK> Yes NAACCR #522 None
Behavior <BLANK> Yes NAACCR #523 None
RX Summ Systemic/Surgery Sequence <BLANK> Yes NAACCR #1639 None
RX Summ Surgery/Radiation Sequence <BLANK> Yes NAACCR #1380 None
Regional Nodes Positive <BLANK> Yes NAACCR #820 None

Initial Context

Staging Methods

Expand All | Collapse All

TNM 7 Stage

Inclusion Table

Histology
8000-8576
8940-8950
8980-8981

Start

Additional Context
Clinical Stage Group = 90
Pathologic Stage Group = 90

Next Step

  1. Parse T
  2. clin_t_prefix
    tmp_clin_t

Next Step

  1. Parse N
  2. clin_n_prefix
    tmp_clin_n

Next Step

  1. Parse M
  2. tmp_clin_m
    clin_m_prefix

Next Step

  1. Parse T
  2. tmp_path_t
    path_t_prefix

Next Step

  1. Parse N
  2. tmp_path_n
    path_n_prefix

Next Step

  1. Parse M
  2. tmp_path_m
    path_m_prefix

Next Step

  1. Determine Default T
  2. Source T
    tmp_path_t
    tmp_clin_t
    tmp_combined_t

Next Step

  1. Determine Default N
  2. tmp_combined_n
    tmp_clin_n
    tmp_path_n
    Source N

Next Step

  1. Determine Default M
  2. tmp_path_m
    tmp_combined_m
    tmp_clin_m
    Source M

Next Step

  1. Histologies Stage
  2. stage_table
    Clinical Stage Group

Next Step

  1. Histologies Path Stage
  2. stage_table
    Pathologic Stage Group

Next Step

  1. Adjustments for No Clin or No Path
  2. tmp_combined_n
    tmp_combined_m
    Source T
    Clinical Stage Group
    Pathologic Stage Group
    Source N
    tmp_combined_t
    Source M

End

Combined Stage

Inclusion Table

Histology
8000-8576
8940-8950
8980-8981

Start

Additional Context
Combined M = 90
Combined N = 90
Combined Stage Group = 90
Combined T = 90

Next Step

  1. Stop if No Clin and No Path
  2. Combined M
    Combined N
    Source T
    tmp_continue
    Combined T
    Combined Stage Group
    Source N
    Source M

Next Step

  1. Combined T
  2. Source T
    tmp_combined_t

Next Step

  1. Combined N for Tis Cancers
  2. tmp_combined_n
    Source N

Next Step

  1. Combined M
  2. tmp_combined_m
    tmp_source_m
    Source M

Next Step

  1. Determine Combined Prefix
  2. cmb_t_prefix

Next Step

  1. Determine Combined Prefix
  2. cmb_n_prefix

Next Step

  1. Determine Combined Prefix
  2. cmb_m_prefix

Next Step

  1. Concatenate T
  2. Combined T

Next Step

  1. Concatenate N
  2. Combined N

Next Step

  1. Concatenate M
  2. Combined M

Next Step

  1. Histologies Path Stage
  2. stage_table
    Combined Stage Group

End

Outputs

Name Default Value Description NAACCR Item
Derived Version {{ctx_alg_version}} None
Derived SEER Clin Stage Group 88 NAACCR #3610
Derived SEER Path Stage Group 88 NAACCR #3605
Derived SEER Combined Stage Group 88 NAACCR #3614
Derived SEER Combined T 88 NAACCR #3616
Derived SEER Combined N 88 NAACCR #3618
Derived SEER Combined M 88 NAACCR #3620
Derived SEER Combined T Source <BLANK> NAACCR #3622
Derived SEER Combined N Source <BLANK> NAACCR #3624
Derived SEER Combined M Source <BLANK> NAACCR #3626