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Ductal adenocarcinoma
Pancreas
Staging
Pancreatic cancers are staged according to the seventh edition of the TNM 
Sobin LH, Gospodarowicz MK, Wittekind Ch. (Eds.)
International Union against Cancer (UICC): TNM Classification of Malignant Tumors
7th Edition
Wiley-Blackwell: Oxford 2009
and AJCC
Edge SB, Byrd DR, Carducci MA, Compton CC, Fritz AG, Greene F, Trotti A. (Eds.)
American Joint Committee on Cancer (AJCC) Cancer Staging Manual
7th
Springer: New York 2009
system. A slightly modified classification has been proposed by the Japanese Pancreas Society 
Isaji S, Kawarada Y, Uemoto S (2004)
Classification of pancreatic cancer: comparison of Japanese and UICC classifications.
Pancreas 28: 231-4
Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010
.
TNM classification of tumours of the pancreas
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, and Trotti A (eds.)
AJCC Cancer Staging Manual
Springer: New York 2009
Sobin LH, Gospodarowicz MK, Wittekind Ch. (Eds.)
International Union against Cancer (UICC): TNM Classification of Malignant Tumors
7th Edition
Wiley-Blackwell: Oxford 2009
Stage grouping
| | | | | | |
| Stage | | T | | N | | M |
| Stage 0 | | Tis
Tis Carcinoma in situ, includes PanIN-3c
| | N0
N0 No regional lymph-node metastasis
| | M0
M0 No distant metastasis
|
| Stage IA | | T1
T1 Tumour limited to the pancreas, 2 cm or less in greatest dimension
| | N0
N0 No regional lymph-node metastasis
| | M0
M0 No distant metastasis
|
| Stage IB | | T2
T2 Tumour limited to the pancreas, more than 2 cm in greatest dimension
| | N0
N0 No regional lymph-node metastasis
| | M0
M0 No distant metastasis
|
| Stage IIA | | T3
T3 Tumour extends beyond pancreas
| | N0
N0 No regional lymph-node metastasis
| | M0
M0 No distant metastasis
|
| Stage IIB | | T1, T2, T3
T1 Tumour limited to the pancreas, 2 cm or less in greatest dimension
T2 Tumour limited to the pancreas, more than 2 cm in greatest dimension
T3 Tumour extends beyond pancreas
| | N1
N1 Regional lymph-node metastasis
| | M0
M0 No distant metastasis
|
| Stage III | | T4
T4 Tumour involves coeliac axis or superior mesenteric artery
| | Any N | | M0
M0 No distant metastasis
|
| Stage IV | | Any T | | Any N | | M1
MI Distant metastasis
|
| T - Primary tumour |
| TX | Primary tumour cannot be assessed |
| T0 | No evidence of primary tumour |
| Tis | Carcinoma in situ, includes PanIN-3c |
| T1 | Tumour limited to the pancreas, 2 cm or less in greatest dimension |
| T2 | Tumour limited to the pancreas, more than 2 cm in greatest dimension |
| T3 | Tumour extends beyond pancreas |
| T4 | Tumour involves coeliac axis or superior mesenteric artery |
| N – Regional lymph nodes |
| NX | Regional lymph nodes cannot be assessed |
| N0 | No regional lymph-node metastasis |
| N1 | Regional lymph-node metastasis |
| M – Distant metastasis |
| M0 | No distant metastasis |
| MI | Distant metastasis |
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