The Sol Goldman Pancreatic Cancer Research Center

How and why is pancreatic cancer staged?

There is considerable overlap between the diagnosis of pancreatic cancer and the staging of the cancer. The results of various diagnostic tests will indicate how far the cancer has progressed and determine the stage. Subsequent decicions about treatment will be based upon the stage assigned.

Although different stages carry different prognoses, it is important to remember that the Median isn't the Message (an excellent article regarding prognoses and statistics by Stephen Jay Gould).

The charts below are part of a very common system used by doctors to stage pancreatic tumors. These particular charts are for pancreatic carcinoma. The staging system varies slightly for tumors of the bile duct or ampulla of Vater.

The stage of a pancreatic cancer is determined by 3 factors: T, N, and M. A value is assigned for each of these factors based on the diagnostic test results. Click on these links to see the how each factor is ranked or scaled.

T= location and size of the tumor
N= evidence of metastases in lymph nodes close to the cancer
M= evidence of distant metastases

Stage Grouping for Primary Tumors of the Exocrine Pancreas
Stage Tumor Regional Lymph Nodes Distant Metastases
Stage 0 Tis N0 M0 M0
Stage IA T1 N0 M0
Stage IB T2 N0 M0
Stage IIA T3 N0 M0
Stage IIB T1
T2
T3
N1
N1
N1
M0
M0
M0
Stage III T4 any N M0
Stage IV any T any N M1 M1

Definition of Tumor (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
Tis In situ carcinoma
T1 Tumor limited to the pancreas, 2 cm or less in greatest dimension T1
T2 Tumor limited to the pancreas, more than 2 cm in greatest dimensionT2
T3 Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric arteryT3
T4 Tumor involves the celiac axis or superior mesenteric artery (unresectable primary tumor)T4

Definition of Regional Lymph Nodes (N)
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis N0
N1 Regional lymph node metastasis N1

The American Cancer Society reports the 5-year survival rates for a number of cancers (http://www.cancer.org/docroot/STT/stt_0.asp). The overall 5-year survival rate for pancreatic cancer is 5.1% (all stages). For patients with pancreatic cancer that has spread to other organs (metastasized) the reported survival rate is 1.8%. this increases to 8.2% for patients with regional disease and to 20.0% for patients with localized disease.