Cervical Esophageal Cancer

Determining the Grade of the Tumor

Pathologists will typically report on the grade of the tumor. This is a qualitative interpretation by the pathologist of how much the cancerous cells resemble normal tissue from that site. There are a number of different grading systems that might be used. The most common system is as follows:

  • GX: Grade cannot be assessed
  • G1: Well differentiated
  • G2: Moderately differentiated
  • G3: Poorly differentiated
  • G4: Undifferentiated

Differentiation refers to how closely the cells taken from a tumor or lesion resemble normal cells from the healthy tissue surrounding the tumor. “Well differentiated” means the cells look similar to normal cells in that area. “Undifferentiated” means the cells look nothing like normal cells in that area.

While it is important to report the tumor’s grade, few doctors use this information to make decisions regarding treatment or prognosis for this particular cancer type.


1 Krause CJ, Carey TE, Ott RW, Hurbis C, McClatchey KD, Regezi JA. Human squamous cell carcinoma. Establishment and characterization of new permanent cell lines. Arch Otolaryngol. Nov 1981;107(11):703-710.

2 Moore C. Smoking and cancer of the mouth, pharynx, and larynx. JAMA: the journal of the American Medical Association. Jan 25 1965;191(4):283-286.

3 Pelucchi C, Gallus S, Garavello W, Bosetti C, La Vecchia C. Cancer risk associated with alcohol and tobacco use: focus on upper aero-digestive tract and liver. Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism. 2006;29(3):193-198.

4 Little MP. Cancer after exposure to radiation in the course of treatment for benign and malignant disease. The lancet oncology. Apr 2001;2(4):212-220.

5 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Esophageal and Esophagogastric Junction Cancers V.2.2016. ©National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 7, 2016. To view the most recent and complete version of the guideline, go online to

6 Modlin IM, Shapiro MD, Kidd M. An analysis of rare carcinoid tumors: clarifying these clinical conundrums. World J Surg. 2005 Jan;29(1):92-101.

7 Vinik, A. I., Thompson, N., Eckhauser, F., & Moattari, A. R. (1989). Clinical features of carcinoid syndrome and the use of somatostatin analogue in its management. Acta Oncologica, 28(3), 389-402.

8 Mariette C, Balon J-M, Piessen G, Fabre S, Van Seuningen I, Triboulet J-P. Pattern of recurrence following complete resection of esophageal carcinoma and factors predictive of recurrent disease. Cancer. 2003;97:1616-1623.

9 Key C and Meisner ALW. Chapter 3: Cancer of the Esophagus, Stomach, and Small Intestine. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.