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WHO Classification of Tumours
Ductal adenocarcinoma
Pancreas


Staging

Pancreatic cancers are staged according to the seventh edition of the TNM
Click for details
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
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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



http://www.cancerstaging.org/staging/posters/pancreas8.5x11.pdf system. A slightly modified classification has been proposed by the Japanese Pancreas Society
Click to access Pubmed
Isaji S, Kawarada Y, Uemoto S (2004)
Classification of pancreatic cancer: comparison of Japanese and UICC classifications.
Pancreas 28: 231-4




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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

Click for details
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, and Trotti A (eds.)
AJCC Cancer Staging Manual
Springer: New York 2009




Click for details
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
StageTNM
Stage 0Tis
Tis Carcinoma in situ, includes PanIN-3c

N0
N0 No regional lymph-node metastasis

M0
M0 No distant metastasis

Stage IAT1
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 IBT2
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 IIAT3
T3 Tumour extends beyond pancreas

N0
N0 No regional lymph-node metastasis

M0
M0 No distant metastasis

Stage IIBT1, 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 IIIT4
T4 Tumour involves coeliac axis or superior mesenteric artery

Any NM0
M0 No distant metastasis

Stage IVAny TAny NM1
MI Distant metastasis



T - Primary tumour
TXPrimary tumour cannot be assessed
T0No evidence of primary tumour
TisCarcinoma in situ, includes PanIN-3c
T1Tumour limited to the pancreas, 2 cm or less in greatest dimension
T2Tumour limited to the pancreas, more than 2 cm in greatest dimension
T3Tumour extends beyond pancreas
T4Tumour involves coeliac axis or superior mesenteric artery


N Regional lymph nodes
NXRegional lymph nodes cannot be assessed
N0No regional lymph-node metastasis
N1Regional lymph-node metastasis


M Distant metastasis
M0No distant metastasis
MIDistant metastasis