BOHR Journal of Cancer Research

Cancer is a critical health concern worldwide, and this chronic disease is gradually growing. In 2020 alone,
19,292,789 new cases were reported globally; by 2025, this figure is expected to rise to 21,618,445. Among the
various cancers, esophageal cancer is considered one of the most aggressive, with a poor survival rate. It currently
ranks eighth in incidence and sixth in mortality among all cancers, and its frequency and mortality are progressively
increasing, with 604,100 new cases and 5,44,000 deaths by 2020. Several staging systems have been proposed
for esophageal cancer, including the Ellis, Japan Esophageal Society, and AJCC/UICC systems. However, since
the AJCC/UICC established their staging criteria, these have been the most widely used and accepted by the
medical community.
The different AJCC Cancer Staging Manual editions have progressively incorporated changes in the esophageal
cancer staging as our understanding, which has been exponentially influenced by various conventional diagnostic
means. The TNM staging system’s editions are updated periodically, but how much have they changed
since the first edition? What have been the main changes introduced in each edition concerning esophageal
cancer? This narrative review aims to answer these questions through a thorough and comparative analysis of
each TNM addition.
The esophageal cancer staging has changed with each TNM edition, allowing a better understanding of it
and applying better therapeutic methods. The last two editions have introduced significant changes with the
incorporation of non-anatomical categories into the staging grouping and the addition of a classification for patients
undergoing neoadjuvant therapy.