Pancreatic cancer staging
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
There are four stages of pancreatic cancer based on the size and extent of cancer spread.
Staging
- The following stages are used for pancreatic cancer:
- Stage 0 (Carcinoma in Situ)
- stage I, cancer has formed and is found in the pancreas only. Stage I is divided into stage IA and stage IB, based on the size of the tumor
- Stage IA: The tumor is 2 centimeters or smaller
- Stage IB: The tumor is larger than 2 centimeters
- stage II, cancer may have spread to nearby tissue and organs, and may have spread to lymph nodes near the pancreas. Stage II is divided into stage IIA and stage IIB, based on where the cancer has spread
- Stage IIA: Cancer has spread to nearby tissue and organs but has not spread to nearby lymph nodes
- Stage IIB: Cancer has spread to nearby lymph nodes and may have spread to nearby tissue and organs
- Stage III, cancer has spread to the major blood vessels near the pancreas and may have spread to nearbylymph nodes
- Stage IV, cancer may be of any size and has spread to distant organs, such as the liver, lung, and peritoneal cavity. It may have also spread to organs and tissues near the pancreas or to lymph nodes.
- Stage grouping of pancreatic cancer:[1]
| Stage grouping of pancreatic cancer: | |||
|---|---|---|---|
| Primary tumor | |||
| 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 |
| TNM Classification for Pancreatic Cancer: | |||
|---|---|---|---|
| Primary tumor | |||
| 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 | |||
| NX | Regional lymph nodes cannot be assessed | ||
| N0 | No regional lymph node metastasis | ||
| N1 | Regional lymph node metastasis | ||
| Distant metastases | |||
| MX | Distant metastasis cannot be assessed | ||
| M0 | No distant metastasis | ||
| M1 | Distant metastasis | ||
- Staging and TNM (tumour, lymph node, metastasis) classification related to incidence, treatment, and prognosis: [2]
| Staging and TNM Classification related to Incidence, Treatment, and Prognosis | ||||
|---|---|---|---|---|
| Stage | TNM Classification | Clinical Classification | Incidence at diagnosis (%) | 5-year survival rate (%) |
| 0 | Tis, N0, M0 | Resectable | 7.5 | 15.2 |
| IA | T1, N0, M0 | — | — | — |
| IB | T2, N0, M0 | — | — | — |
| IIA | T3, N0, M0 | — | — | — |
| IIB | T1-3, N1, M0 | Locally advanced | 29.3 | 6.3 |
| III | T4, any N, M0 | — | — | — |
| IV | Any T, any N, M1 | Metastatic | 47.2 | 1.6 |
Refrences
- ↑ 1.0 1.1 Seufferlein T, Bachet JB, Van Cutsem E, Rougier P, ESMO Guidelines Working Group (2012). "Pancreatic adenocarcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Ann Oncol. 23 Suppl 7: vii33–40. doi:10.1093/annonc/mds224. PMID 22997452.
- ↑ 2.0 2.1 Bond-Smith G, Banga N, Hammond TM, Imber CJ (2012). "Pancreatic adenocarcinoma". BMJ. 344: e2476. doi:10.1136/bmj.e2476. PMID 22592847.