Grading esophageal cancer

To find out the grade of esophageal cancer, the pathologist looks at a tissue sample from the tumour under a microscope. The pathologist gives esophageal cancer a grade from 1 to 3. The lower the number, the lower the grade.

The grade is a description of how the cancer cells look and act compared to normal cells. How different the cancer cells are is described as differentiation.

Low grade means that the cancers cells are well or moderately differentiated. They look and act much like normal cells. Lower grade cancer cells tend to be slow growing and are less likely to spread.

High grade means that the cancer cells are poorly differentiated or undifferentiated. They look and act less normal, or more abnormal. Higher grade cancer cells tend to grow more quickly and are more likely to spread.

Knowing the grade may give your healthcare team an idea of how quickly the cancer may be growing and how likely it is to spread. This helps them plan your treatment. The grade can also help the healthcare team predict how you might respond to treatment.

Expert review and references

  • Lugli A & Jass JR . Gastrointestinal Cancer: Pathology and Molecular Pathology. Kelsen, D. P., Daly, J. M., Kern, S. E., Levin, B., Tepper, J. E., & Van Cutsem, E. (eds.). Principles and Practice of Gastrointestinal Oncology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2008: 2: 15-26.
  • Esophageal and esophagogastric junction cancers. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. National Comprehensive Cancer Network; 2013.