Cancer Treatment Centers of America

Pancreatic cancer stages

Making an educated treatment decision begins with the stage, or progression, of the disease. The stage of pancreatic cancer is one of the most important factors in evaluating treatment options.

In order to examine the progression of the disease, your doctor may use several tools to determine if cancer growth extends beyond the pancreas.

For example, your doctor may perform additional tests, such as a laparoscopy, chest X-ray or bone scan. A laparoscopy involves a small incision in the abdomen to closely explore the normality of the area. To ensure that the cancer is not in your chest, your doctor might also take a chest X-ray. Finally, a bone scan can tell whether or not cancer has spread to the bones.

TNM system

The pancreatic cancer staging process often uses the AJCC TNM system, which uses three criteria to judge the stage of the cancer: the size and location of the primary tumor (T), the adjacent lymph nodes (N) and if the tumor has spread to the rest of the body (M).

Primary tumor (T)

  • TX - Primary tumor cannot be assessed.
  • T0 - No evidence of primary tumor.
  • Tis - Carcinoma in situ.
  • T1 - Tumor limited to pancreas, 2 cm or less in greatest dimension.
  • T2 - Tumor limited to pancreas, more than 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.

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