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Pancreatic Cancer

The American Joint Committee on Cancer (AJCC) TNM staging system for pancreatic tumors

T categories

TX

The main tumor cannot be assessed.

T0

No evidence of a primary tumor.

Tis

Carcinoma in situ (very few tumors are found at this stage)

T1

The cancer has not spread beyond the pancreas and is smaller than 2 cm (about ¾ inch) across.

T2

The cancer has not spread beyond the pancreas but is larger than 2 cm across.

T3

The cancer has spread from the pancreas to surrounding tissues near the pancreas but not to major blood vessels or nerves.

T4

The cancer has extended further beyond the pancreas into nearby large blood vessels or nerves.

N categories

NX

Regional lymph nodes cannot be assessed.

N0

Regional lymph nodes (lymph nodes near the pancreas) are not involved.

N1

Cancer has spread to regional lymph nodes.

M categories

M0

The cancer has not spread to distant lymph nodes (other than those near the pancreas) or to distant organs such as the liver, lungs, brain, etc.

M1

Distant metastasis is present.


Stage grouping for pancreatic cancer

Stage 0

(Tis, N0, M0)

The tumor is confined to the top layers of pancreatic duct cells and has not invaded deeper tissues. It has not spread outside of the pancreas. These tumors are sometimes referred to as pancreatic carcinoma in situ or pancreatic intraepithelial neoplasia III (PanIn III).

Stage IA

(T1, N0, M0)

The tumor is confined to the pancreas and is less than 2 cm in size. It has not spread to nearby lymph nodes or distant sites.

Stage IB

(T2, N0, M0)

The tumor is confined to the pancreas and is larger than 2 cm in size. It has not spread to nearby lymph nodes or distant sites.

Stage IIA

(T3, N0, M0)

The tumor is growing outside the pancreas but not into large blood vessels. It has not spread to nearby lymph nodes or distant sites.

Stage IIB

(T1-3, N1, M0)

The tumor is either confined to the pancreas or growing outside the pancreas but not into nearby large blood vessels or major nerves. It has spread to nearby lymph nodes but not distant sites.

Stage III

(T4, Any N, M0)

The tumor is growing outside the pancreas into nearby large blood vessels or major nerves. It may or may not have spread to nearby lymph nodes. It has not spread to distant sites.

Stage IV

(Any T, Any N, M1)

The cancer has spread to distant sites.