Pathology

​Added 06 March 2013

Specimen: specify 

  • Type
  • Procedure 

Tumour: specify 

  • Primary tumour site- cervical esophagus, mid-esophagus, distal esophagus, esophago-gastric junction (EGJ). [Adenocarcinoma arising at the EGJ or within the proximal 5cm of the stomach and involving the EGJ are staged as an esophageal tumour ]
  • Histologic type
  • Histologic grade (well, moderately, poorly differentiated or undifferentiated)
  • Size (Longitudinal tumour dimension, semi-circumferential/ circumferential lesion)
  • Microscopic tumour extension/invasion
  • Lymph-Vascular invasion (present/absent)
  • Surgical margins: proximal, distal, omental (radial), deep (for endoscopic resections); state if involved by dysplasia or invasive carcinoma; state closest approach of invasive carcinoma to margin in mm.) 
  • Treatment effect(post neo-adjuvant therapy, if applicable) (present/absent)
  • Status of background mucosa (i.e. Barrett’s esophagus, dysplasia, etc.)
  • Lymph node status (x of y lymph nodes positive)
  • HER2-neu testing in gastroesophageal adenocarcinoma:
    • by immunohistochemistry (IHC)
    • fluorescence in-situ hybridization if IHC is 2+
  • pTNM tumour stage (AJCC 7th edition)

​Primary Tumour (pT) (Note: this is optional)

  • ​pTX: Cannot be assessed
  • pT0: No evidence of primary tumour
  • pTis: High-grade dysplasia
  • pT1: Tumour invades lamina propria, muscularis mucosae, or submucosa
  • pT1a: Tumour invades lamina propria or muscularis mucosae
  • pT1b: Tumour invades submucosa
  • pT2: Tumour invades muscularis propria
  • pT3: Tumour invades adventitia
  • pT4: Tumour invades adjacent structures (specify): ______________________
  • pT4a: Resectable tumour invading pleura, pericardium, or diaphragm
  • pT4b: Unresectable tumour invading other adjacent structures, such as aorta, vertebral body, trachea, etc

Regional Lymph Nodes (pN) 

  • ​pNX: Cannot be assessed
  • pN0: No regional lymph node metastasis
  • pN1: Regional lymph node metastasis involving 1 to 2 nodes
  • pN2: 3 to 6 nodes involved
  • pN3: 7 or more nodes involved

Distant Metastasis (pM)

  • Not applicable
  • pM1: Distant metastasis (specify site(s)) ​