Staging Diagram and Classification Criteria-TNM  

Investigations for Staging

All patients with esophageal cancer should undergo chest x-ray and barium swallow study, as well as endoscopy and biopsy. CT scans of chest and abdomen are essential to assess local invasion within the mediastinum and the presence or absence of suspicious lymph nodes, or liver involvement. Endoscopic ultrasound is increasingly useful. Mediastinoscopy may be necessary to assess worrisome lymph nodes and laparoscopy may be helpful to assess presence or absence of intra-abdominal spread or liver involvement. PET scanning is becoming more widely used, but remains investigational at this time. Other investigations for distant metastases should be directed by clinical suspicion.