Stage 2 oesophageal cancer

The stage of your cancer tells the doctor how far it has grown and if it has spread.

What is stage 2 oesophageal cancer?

Stage 2 oesophageal cancer means your cancer might have spread as far as the outer layer covering your oesophagus.

Some stage 2 cancers have also spread into 1 or 2 nearby lymph nodes. But the cancer hasn’t spread to other body parts, structures or distant organs.

This is a simplified description. We have much more detailed information below on this page. 

Staging is very complicated. It depends on:

  • what type of oesophageal cancer you have (squamous cell or adenocarcinoma)
  • the grade of your cancer (how abnormal the cells look)
  • whether doctors stage your cancer using tests and scans (clinical staging) or after surgery (pathological staging) 

For some stage 2 squamous cell oesophageal cancers, the doctor also considers where the cancer is in your oesophagus.

Your oesophagus has 3 parts – the upper, middle and lower part.

Diagram showing the parts of the oesophagus

When you read the information on this page, it's helpful to know what type of oesophageal cancer you have and whether the doctor is using pathological or clinical staging. Talk to your specialist doctor or nurse if you are unsure. They can help you understand more about your cancer stage. 

You can call the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.

Staging systems

Doctors use different systems to stage oesophageal cancer. This page is about stage 2 cancer, which is part of the number staging system. This system has 5 stages, stage 0 (high grade dysplasia) to stage 4.

This page also tells you what stage 2 means in the TNM system. This system describes:

  • the size of the primary tumour (T)
  • whether the cancer has spread to the lymph nodes (N)
  • whether the cancer has spread to another part of the body (M)

Squamous cell cancer

Squamous cell cancers develop from squamous cells that make up the inner lining of your oesophagus.

Clinical staging means your doctor uses test and scan results to stage your cancer. This is different to pathological staging, which doctors use after surgery.

Your doctor might tell you your clinical stage to begin with. And if you go on to have surgery, your stage might change when the doctor finds out your pathological stage.  

Stage 2 squamous cell cancer (clinical stage) can be any grade and anywhere in the oesophagus.

The cancer has grown into the thick muscle wall or outer layer (adventitia) of the oesophagus. It might have spread to 1 or 2 nearby lymph nodes.

In TNM staging, stage 2 includes:

  • T2, N0 or N1, M0
Diagram showing stage 2 squamous cell oesophageal cancer (clinical-stage) 1 of 2
  •  T3, N0, M0
Diagram showing stage 2 squamous cell oesophageal cancer (clinical stage) 2 of 2

Stage 2 squamous cell (pathological stage) depends on the grade of your cancer and where it is in the oesophagus.

It’s split into 2 groups - 2A and 2B.

Stage 2A means the cancer has grown into the thick muscle wall or outer layer (adventitia) of your oesophagus. It hasn’t spread to nearby lymph nodes.

In TNM staging stage 2A means:

  • T2 or T3, N0, M0.
Diagram showing stage 2A squamous cell oesophageal cancer (pathological stage)

Stage 2B means the cancer has grown into either the supportive tissue (submucosa) or outer layer of your oesophagus. It might have spread to 1 or 2 nearby lymph nodes.

In TNM staging, stage 2B can include:

  • T3, N0, M0
Diagram showing stage 2B squamous cell oesophageal cancer (pathological stage) 1 of 2
  • T1, N1, M0.
Diagram showing stage 2B squamous cell oesophageal cancer (pathological-stage) 2 of 2

Adenocarcinoma

Adenocarcinomas are cancers that develop in gland cells. These cells make mucus in the lining of the oesophagus.

Clinical staging means your doctor uses test and scan results to stage your cancer. This is different to pathological staging, which doctors use after surgery. 

Your doctor might tell you your clinical stage to begin with. And if you go on to have surgery, your stage might change when the doctor finds out your pathological stage.  

Stage 2 adenocarcinoma (clinical stage) is in any part of the oesophagus and is any grade.

It’s split into 2 groups - 2A and 2B.

Stage 2A means the cancer has grown no further than the supportive tissue (submucosa). But it has spread to 1 or 2 nearby lymph nodes.

In TNM staging, stage 2A is:

  • T1, N1, M0
Diagram showing stage 2A oesophageal adenocarcinoma (clinical-stage)

Stage 2B means the cancer has grown into the thick muscle wall of the oesophagus. It hasn't spread to any lymph nodes. 

In TNM staging, stage 2B is:

  • T2, N0, M0.
Diagram showing stage 2B oesophageal adenocarcinoma (clinical-stage)

Stage 2 adenocarcinoma (pathological stage) is in any part of the oesophagus. It depends on the grade of your cancer.

It’s split into 2 groups - 2A and 2B.

Stage 2A means the cancer has grown into the thick muscle wall. It has not spread to nearby lymph nodes.

In TNM staging stage 2A means:

  • T2, N0, M0
Diagram showing stage 2A oesophageal adenocarcinoma (pathological-stage)

Stage 2B means the cancer has grown into either the supportive tissue (submucosa) or outer layer (adventitia) of your oesophagus. It might have spread to 1 or 2 nearby lymph nodes.

In TNM staging, stage 2B includes:

  • T3, N0, M0.
Diagram showing stage 2B oesophageal adenocarcinoma (pathological-stage) 1 of 2
  • T1, N1, M0.
Diagram showing stage 2B oesophageal adenocarcinoma (pathological-stage) 2 of 2

Treatment for stage 2 oesophageal cancer

Your treatment depends on whether you have squamous cell cancer or adenocarcinoma. Most people who have surgery will have treatment before the surgery (neoadjuvant treatment).

For squamous cell cancer you usually have chemoradiotherapy. And then you either have:

  • surgery to remove part or all of your oesophagus
  • no further treatment and the doctors keep a close eye on you - this is called active surveillance

For adenocarcinoma you either have:

  • chemotherapy before surgery
  • chemotherapy before and after surgery
  • chemoradiotherapy before surgery

Some people might have immunotherapy treatment if there are any cancer cells left after surgery.

About other stages

  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2017

  • Oesophago-gastric cancer: assessment and management in adults  
    National Institute for Health and Care Excellence (NICE), January 2018

  • Nivolumab for adjuvant treatment of resected oesophageal or gastro-oesophageal junction cancer
    National Institute for Health and Care Excellence (NICE), November 2021

  • Oesophageal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
    R Obermannova and others
    Annals of Oncology, 2022. Volume 33. Pages 992-1004

  • Oesophageal cancer
    EC Smyth and others
    Nature Reviews Disease Primers, 2018. Volume 3. Pages 1-44

  • Oesophageal cancer
    J Lagergren and others
    The Lancet, 2017. Volume 390. Pages 2383-2396

Last reviewed: 
18 Aug 2023
Next review due: 
18 Aug 2026

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