Pancreatic Cancer — TNM

AJCC 8th edition (2017) — pancreatic ductal adenocarcinoma

T — primary tumour

Tis — carcinoma in situ (high-grade PanIN, or IPMN/MCN with high-grade dysplasia)

T1 — ≤ 2 cm in greatest dimension

T2 — > 2 to ≤ 4 cm

T3 — > 4 cm

T4 — involves the coeliac axis, superior mesenteric artery, and/or common hepatic artery (any size)

N — regional lymph nodes

N0 — no regional lymph node metastasis

N1 — metastasis in 1–3 regional lymph nodes

N2 — metastasis in ≥ 4 regional lymph nodes

M — distant metastasis

M0 — no distant metastasis

M1 — distant metastasis

Evidence

Original publication

Validation of the American Joint Committee on Cancer 8th-edition staging system for pancreatic ductal adenocarcinoma. The 8th edition redefines T by tumour size (T1 ≤ 2, T2 > 2–4, T3 > 4 cm) and N by the number of positive nodes (N1 1–3, N2 ≥ 4), improving prognostic separation over the 7th edition.

European Journal of Surgical Oncology, 2019

Open source

Guideline

Amin MB, Edge SB, Greene FL, et al., eds. AJCC Cancer Staging Manual, 8th edition. Chicago: Springer; 2017. T4 (coeliac axis / SMA / common hepatic artery involvement) denotes locally advanced, generally unresectable disease. Confirm against the manual.

Last reviewed: 2026-09

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