The stage of a malignant tumor is an assessment of how much the tumor has grown and spread throughout the body. From the correct definition of the stage of the disease depends on the choice of treatment methods, as well as the survival prognosis.

The stage (or degree) of pancreatic cancer is diagnosed based on the results of diagnosis, biopsy, and tests described in the article Diagnosis of pancreatic cancer (modern methods)

TNM-classification of pancreatic cancer stages

Staging by the TNM system summarizes the size of the tumor and the presence of metastases.

T (Tumor) describes the size of the primary tumor and whether it has grown into the tissue.

N (Nodes) means whether cancer affected lymph nodes.

M (Metastasis) indicates whether the tumor has affected other organs of the body.

The alphabetic and numeric numbers that follow T, N and M give extended information about characteristics of pancreatic cancer.

What does T mean in the TNM classification?

  • TX - the primary tumor cannot be assessed.
  • T0 - the primary tumor was not detected.
  • Tis - carcinoma in situ (pancreatic cancer in situ) - the formation is localized in the upper layers of the gland cells (this type of disease is rare).
  • T1 - tumor up to 2 cm; did not grow in the tissue outside the pancreas.
  • T2 - the formation did not grow in the tissue outside the pancreas, but it is larger than 2 cm.
  • T3 - the tumor affected tissues outside the pancreas, but did not affect large blood vessels and/or nerves.
  • T4 - the tumor has grown into large vessels and/or nerves.

What does N stand for in the TNM classification?

  • NX - it is impossible to assess the damage to nearby lymph nodes.
  • N0 - the tumor did not spread to the nearby (local) lymph nodes.
  • N1 - cancer has spread to the lymph nodes.

What does M stand for in the TNM classification?

  • M0 - the tumor did not spread to distant lymph nodes and organs (brain, lungs, liver).
  • M1 - the tumor metastasized to distant lymph nodes and/or organs.

AJCC stage of pancreatic cancer (0, I, II, III, IV)

Stepwise staging of AJCC was developed by specialists of the American Joint Committee on Cancer (American Joint Committee on Cancer). It uses the foundations of the TNM system - the size of the tumor, the presence of secondary formations in lymph nodes and distant organs.

There are 5 degrees of pancreatic cancer in this system of stages.

Stage

TNM

Description

0

Tis

N0

M0

The tumor is confined to the upper layers of the cells of the pancreas and does not grow into deeper tissues.

The tumor did not spread beyond the pancreas.

IA

T1

N0

M0

The tumor is localized in the pancreas and has a size up to 2 cm (T1).

Cancer has not spread to the nearest lymph nodes (N0) or distant parts of the body (M0).

IB

T2

N0

M0

The tumor is localized in the pancreas and has a size larger than 2 cm (T2).

Cancer did not spread to the local lymph nodes (N0) or distant organs (M0).

IIA

T3

N0

M0

The tumor sprouted beyond the pancreas but did not affect large blood vessels or nerves (T3).

Cancer did not spread to the lymph nodes (N0) or distant sites (M0).

IIB

T1-T3

N1

M0

The tumor is either confined to the pancreas, or grows outside the pancreas, but not in the large blood vessels or nerves (T1-T3).

Cancer spreads to the lymph nodes (N1), but not to distant organs (M0).

III

T4

N0-N1

M0

The tumor grows outside the pancreas and has affected large blood vessels or nerves (T4).

Cancer does not spread/spreads to the lymph nodes (N). The tumor does not extend to distant organs (M0).


IV

T0-T4

N0-N1

M1

The tumor can be of any size but extends to distant organs (M1).