Pancreatic Cancer Staging 

Updated: Dec 23, 2019
Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS 

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, 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.