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Staging of pancreatic cancer

Pancreatic cancer is classified by the TNM classification system. This classification applies only to adenocarcinomas in exocrine pancreatic tissue. The TNM system assesses the tumor (T), lymph nodes (N), and metastasis (M) at the time of diagnosis. The TNM classification differentiates between the clinical classification (TNM) and the pathological classification (pTNM).

Primary tumor (T)

  • pTX   Primary tumor cannot be assessed
  • pT0   No evidence of primary tumor
  • pTis  Carcinoma in situ


  • pT1   Tumor limited to the pancreas ≤ 2 cm
  • pT2   Tumor limited to the pancreas > 2 cm


  • pT3   Tumor has spread outside the pancreas without involving the coeliac axis or superior mesenteric artery
  • pT4   Tumor infiltrates the coeliac trunk or superior mesenteric artery

Regional lymph nodes (N)

  • pNX   Regionale lymph nodes cannot be assessed
  • pN0   No regional lymph node metastasis
  • pN1   Regional lymph node metastasis 

Metastasis (M)

  • pMX    Metastasis cannot be assessed
  • pM0    No metastasis
  • M1    Metastasis

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