The American Joint Committee on Cancer (AJCC) tumor/node/metastasis (TNM) classification and staging system for pancreatic cancer are provided below.[1, 2, 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: includes high-grade pancreatic intraepithelial neoplasia (PanIn-3), intraductal papillary mucinous neoplasm with high-grade dysplasia, intraductal tubulopapillary neoplasm with high-grade dysplasia, and mucinous cystic neoplasm with high-grade dysplasia |
T1 |
Tumor limited to the pancreas, ≤2 cm in greatest dimension T1a - Tumor ≤0.5 cm in greatest dimension T1b - Tumor >0.5 cm and < 1 cm in greatest dimension T1c - Tumor 1–2 cm in greatest dimension |
T2 |
Tumor limited to the pancreas, >2 cm and ≤4 cm in greatest dimension |
T3 |
Tumor >4 cm in greatest dimension |
T4 |
Tumor involves the celiac axis, superior mesenteric artery, and/or common hepatic artery, regardless of size |
Regional lymph nodes (N) |
|
NX |
Regional lymph nodes cannot be assessed |
N0 |
No regional lymph node metastasis |
N1 |
Metastasis in 1-3 regional lymph nodes |
N2 |
Metastasis in ≥4 regional lymph nodes |
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,T2,T3 |
N1 |
M0 |
III |
T1,T2,T3 |
N2 |
M0 |
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.