Esophageal cancer T3 belongs to which stage?

Written by Peng Li Bo
Oncology
Updated on September 28, 2024
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For the staging of esophageal cancer, it not only depends on the T stage, but also on the N and M stages. If we are just considering the T stage, it is T3. If there are no N0 and M0 stages, it is relatively early and surgery can be considered. However, if looking only at T3 and the N stage involves lymph node involvement (N1, N2, or N3), with regional or distant lymph node metastasis, then the staging of the esophageal cancer is relatively late. Furthermore, if there is an M stage, which indicates the presence of distant organ metastasis, then it is classified as advanced stage. Therefore, the T stage alone for esophageal cancer does not determine whether it is early, intermediate, or late stage. It is necessary to look in conjunction with the N and M stages to determine the overall staging.

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How is esophageal cancer treated if it has not spread?

If esophageal cancer is clinically assessed as not having spread, surgical treatment is the first choice for patients. Since esophageal cancer surgery is a major operation, it is recommended that patients undergo surgery in a specialized hospital. Of course, for some older patients with poor cardiopulmonary function, if the pathology is squamous cell carcinoma, it is advisable to consider radiotherapy, because this tumor is relatively sensitive to radiation and often achieves better clinical outcomes. However, compared to surgical resection, the effects might be less favorable. For patients in generally good condition, surgery combined with radiation therapy can reduce the likelihood of postoperative recurrence and metastasis.

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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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Late-stage symptoms of esophageal cancer

What are the symptoms of late-stage esophageal cancer? Because in the early stages of esophageal cancer, the symptoms are often not very obvious, which leads many people to overlook them. By the time they feel very uncomfortable and seek medical advice, the cancer is generally in the middle to late stages. One common symptom in the later stages is progressive difficulty swallowing, which is a main symptom presented by many patients at the time of consultation. However, this symptom generally occurs only when about two-thirds of the esophagus's circumference has been infiltrated by the tumor, making swallowing difficulties a late-stage symptom. Other symptoms of late-stage esophageal cancer include hoarseness if the tumor compresses the recurrent laryngeal nerve, belching if it invades the diaphragmatic nerves, and symptoms like breathing difficulties and coughing if it compresses the airway.

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Will esophageal cancer recur after resection?

After the removal of esophageal cancer, there is indeed a possibility of recurrence. This is because not only are there tumors on the esophagus, but some mediastinal lymph nodes around the esophagus may also have metastasized. It must be acknowledged that thoracic surgeons will definitely remove the tumor completely during surgery, but they can only remove the tumors that are visible to the naked eye. Many tumor cells that cannot be seen by the naked eye are impossible to remove. If the cancer is at a relatively advanced stage, many of these invisible tumor cells cannot be eliminated, just like air is invisible but still exists. Therefore, invisible does not mean there are no cancer cells. Thus, if there is no follow-up auxiliary treatment to kill the cancer cells, the cancer may very likely recur.

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How is esophageal cancer staged?

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.