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Staging of Pancreatic Cancer

Staging is a method of describing pancreas cancer based on how far it has spread (metastasize). Pancreatic tumors may be staged based on the TNM (tumor, node, metastasis) system, or a numbered system. It is used to describe the size of a primary tumor (T), whether there are lymph nodes with cancer cells in them (N), and whether the cancer has spread (metastasized) to a different part of the body (M).

  • T values range from 1 to 4, with 1 being a small tumor and 4, a large one
  • N values range from 0 to 3, with 0 meaning no positive lymph nodes and 3 indicating many positive nodes (positive node means presence of cancer)
  • The M value is either 0 or 1, with 0 meaning the cancer has not spread (metastasized) and 1 meaning that it has spread

The following numerical stages also may be used for pancreatic cancer:

Ralph Hruban World-renowned pancreatic cancer pathology expert, Ralph Hruban

Stage 0 (Carcinoma in Situ)
Abnormal cells are found in the lining of the pancreas. The cells may become cancerous and spread (metastasized)  into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I
Cancer is found in the pancreas only. Stage I is divided based on the size of the tumor. In Stage IA, the tumor is two centimeters or smaller. In Stage IB, the tumor is larger than two centimeters.

Stage II
The cancer may have spread (metastasized) to nearby tissue and organs or lymph nodes near the pancreas. Stage II is divided into Stage IIA and Stage IIB, based on where the cancer has spread. In Stage IIA, cancer has spread to nearby tissue and organs but not to the lymph nodes. In Stage IIB, the cancer has spread to nearby lymph nodes and may have also spread to nearby tissue and organs.

Stage III
The cancer has spread to the major blood vessels near the pancreas and may have spread to nearby lymph nodes.

Stage IV
The cancer may be of any size and have spread to distant organs, such as the liver, lung, and peritoneal cavity. It may als have spread to organs and tissues near the pancreas or to the lymph nodes.


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