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Stage Information for Pancreatic Cancer

    The staging system for pancreatic exocrine cancer continues to evolve. The importance of staging beyond that of resectable and unresectable is uncertain since state-of-the-art treatment has demonstrated little impact on survival. To communicate a uniform definition of disease, however, knowledge of the extent of the disease is necessary. Cancers of the pancreas are commonly identified by the site of involvement within the pancreas. Surgical approaches differ for masses in the head, body, tail, or uncinate process of the pancreas.

    Definitions of TNM

    The American Joint Committee on Cancer has designated staging by TNM classification to define pancreatic cancer.[1]

    Table 1. 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 2. 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 3. 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.

    Table 4. Anatomic Stage/Prognostic Groupsa

    StageTNM
    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.
    0TisN0M0
    IAT1N0M0
    IBT2N0M0
    IIAT3N0M0
    IIBT1N1M0
    T2N1M0
    T3N1M0
    IIIT4Any NM0
    IVAny TAny NM1

    References:

    1. 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.

      WebMD Public Information from the National Cancer Institute

      Last Updated: February 25, 2014
      This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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