Pancreatic Cancer Staging 

Updated: Jan 04, 2017
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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TNM Classification for Pancreatic Cancer

The American Joint Committee on Cancer (AJCC) tumor/node/metastasis (TNM) classification and staging system for pancreatic cancer are provided below. [1, 2] Note that these are based on the AJCC Cancer Staging Manual, 7th Edition (2010). Although the 8th edition has been published, implementation of the new system has been delayed until January 1, 2018. The AJCC advises that, "all newly diagnosed cases through December 31st 2017 should be staged with the 7th edition." [3]

Table 1. TNM Classification for Pancreatic Cancer (Open Table in a new window)

Primary tumor (T)

TX

Primary tumor cannot be assessed

T0

No evidence of primary tumor

Tis

Carcinoma in situ

T1

Tumor limited to the pancreas, ≤2 cm in greatest dimension

T2

Tumor limited to the pancreas, >2 cm in greatest dimension

T3

Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery

T4

Tumor involves the celiac axis or the superior mesenteric artery (unresectable primary tumor)

Regional lymph nodes (N)

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

Regional lymph node metastasis

Distant metastasis (M)

M0

No distant metastasis

M1

Distant metastasis

Table 2. Anatomic stage/prognostic groups (Open Table in a new window)

Stage

T

N

M

0

Tis

N0

M0

IA

T1

N0

M0

IB

T2

N0

M0

IIA

T3

N0

M0

IIB

T1

N1

M0

T2

N1

M0

T3

N1

M0

III

T4

Any N

M0

IV

Any T

Any N

M1

See Pancreatic Adenocarcinoma Imaging: What You Need to Know, a Critical Images slideshow, to help identify which imaging studies to use to identify and evaluate this disease.