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Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)

Note: The American Joint Committee on Cancer has published the 7th edition of the AJCC Cancer Staging Manual, which for the first time incorporates pancreatic neuroendocrine tumors in the same staging system as pancreatic exocrine tumors.[1] The classification of these tumors as benign versus malignant is not always consistent, so the AJCC recommends that all pancreatic neuroendocrine tumors be staged using this system and reported to cancer registries. It also recommends that the protocol developed by the College of American Pathologists for endocrine pancreatic tumors be used to examine and stage specimens.[2]

Definitions of TNM

The American Joint Committee on Cancer has designated staging by TNM classification to define pancreatic neuroendocrine tumors (islet cell tumors).[1]

Table 2. Primary Tumor (T)a

a Reprinted with permission from AJCC: Exocrine and endocrine pancreas. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 241-9.
b This also includes the "PanInIII" classification.
TXPrimary tumor cannot be assessed.
T0No evidence of primary tumor.
TisCarcinomain situ.b
T1Tumor limited to the pancreas, ≤2 cm in greatest dimension.
T2Tumor limited to the pancreas, >2 cm in greatest dimension.
T3Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery.
T4Tumor involves the celiac axis or the superior mesenteric artery (unresectable primary tumor).

Table 3. Regional Lymph Nodes (N)a

a Reprinted with permission from AJCC: Exocrine and endocrine pancreas. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 241-9.
NXRegional lymph nodes cannot be assessed.
N0No regional lymph node metastasis.
N1Regional lymph node metastasis.

Table 4. Distant Metastasis (M)a

a Reprinted with permission from AJCC: Exocrine and endocrine pancreas. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 241-9.
M0No distant metastasis.
M1Distant metastasis.
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