Squamous Carcinoma of the Esophagus
Grading / Staging / Report
Grading
- No widely accepted well described, tested grading scheme
- WHO recommendation
- Well differentiated – Large squamous differentiating cells predominate over small basaloid cells
- Poorly differentiated - Small basaloid cells predominate over large squamous differentiating cells
- Moderately differentiated – Intermediate mixtures, should make up about 2/3 of cases
- Undifferentiated
- Grading based on differentiation and cytologic features is not a good predictor of behavior
- Following scheme has been proposed as predictive of 5 year survival (Sarbia 1995)
- Points are allocated as indicated in the table
|
1 |
2 |
3 |
4 |
| Pattern of invasion | Pushing, well defined margins | Infiltrating solid cords and bands | Small groups of dissociated cells | Marked cellular discohesion |
| Inflammatory response | Marked | Moderate | Slight | None |
- Cases are then stratified based on the sum of the two scores
- Group I – 2 or 3 points
- Group II – 4 points
- Group III – 5 or 6 points
- Group IV – 7 or 8 points
- If the complete scheme is not used, it is probably worthwhile to comment on the pattern of invasion and inflammatory response
Staging
- Same TNM for esophageal squamous and adenocarcinomas
