Criteria

American Joint Committee on Cancer TNM staging system (8th edition)[119]

The American Joint Committee on Cancer (AJCC) staging system describes the extent of disease based on the following anatomical factors: size and extent of the primary tumour (T); regional lymph node involvement (N); and presence or absence of distant metastases (M).

Non-anatomical prognostic factors (e.g., tumour grade, signet ring cell histology, biomarkers) may be used to supplement the staging of certain cancers.

Paris classification - submucosal (SM) staging[120][121][122]

Assessment of depth of submucosal invasion following endoscopic resection is important as it is strongly associated with the risk of lymph node metastases.[123] The submucosa can be divided into thirds (SM1/SM2/SM3). Measurement of the depth of invasion below the original muscularis mucosae is used to determine SM staging. The most commonly used staging system for oesophageal adenocarcinoma proposes the following cut-offs:[120]

  • SM1: >0 to ≤500 micrometres

  • SM2 - SM3: >500 micrometres

For squamous cell carcinoma, a cut-off of 200 micrometres for SM1 has been suggested.[124]

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