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About stages and grades

The stage of a cancer tells you how big it is and whether it has spread. The grade means how abnormal the cells look under the microscope. The stage and grade help your doctor decide which treatment you need.

Staging oesophageal cancer

The tests and scans you have to diagnose your cancer will give some information about the size of your cancer and whether it has spread (the stage). But your doctor might not be able to tell you the exact stage until you have surgery.

There are different ways of staging oesophageal cancer. There is a TNM system and a number staging system.

TNM staging

The TNM staging system is the most common way that doctors stage oesophageal cancer. TNM stands for Tumour, Node, Metastasis.

Number staging

Doctors may also use a number staging system. There are 5 main stages - stage 0 to stage 4. 


The grade of a cancer tells you how much the cancer cells look like normal cells.

The grade gives your doctor an idea of how the cancer might behave and what treatment you need.

The grades of cancer cells are from 1 to 3:

  • grade 1 (low grade) look most like normal cells
  • grade 2 look a bit like normal cells
  • grade 3 (high grade) look very abnormal and not like normal cells


Doctors sometimes use the terms well differentiated, moderately differentiated or poorly differentiated to describe the grade of your cancer. As normal cells grow and mature, they become specialised for their role and place in the body.  This is called differentiation. 

Cancer cells can look very like normal cells and are described as well differentiated or low grade. These cancers are more likely to grow slowly.

If the cancer cells look underdeveloped and nothing like a normal cell, they are known as undifferentiated or high grade. These cancers tend to grow and spread more quickly than low grade cancers.

Last reviewed: 
07 Aug 2019
  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer, Springer, 2017

  • Principles and practice of oncology (11th edition)
    VT de Vita, S Hellman and SA Rosenberg
    Lippincott, Williams and Wilkins, 2019

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