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This Article Full Text CME: Take the course for this article: Tumor-Node-Metastasis Staging of Pancreatic Adenocarcinoma All Versions of this Article: CA.2007.0012v1 58/2/111    most recent Submit a letter to the editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Katz, M. H. G. Articles by Evans, D. B. Search for Related Content PubMed PubMed Citation Articles by Katz, M. H. G. Articles by Evans, D. B.

Tumor-Node-Metastasis Staging of Pancreatic Adenocarcinoma

Dr. Katz is Fellow, Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Dr. Hwang is Assistant Professor, Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Dr. Fleming is Associate Professor, Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Dr. Evans is Professor, Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.

    ABSTRACT

Accurate disease staging of patients with pancreatic cancer is essential to divide patients into prognostic subgroups, to allow delivery of stage-specific therapies, and to facilitate meaningful discussions between physicians and patients regarding management and expected outcomes. The tumor-node-metastasis staging system of the American Joint Commission on Cancer has undergone significant revisions over the past 2 decades. In its current form, the system places an emphasis on preoperative clinical staging and facilitates division of patients with pancreatic cancer into 4 groups based on a determination of local resectability and the presence or absence of distant disease as determined on high-quality cross-sectional imaging. A modern understanding of local tumor factors that influence technical resectability is incorporated into the algorithm. In this review, we examine the American Joint Commission on Cancer staging system, describe the rationale for its use, and demonstrate how it is a clinically relevant tool for the staging and management of patients with pancreatic cancer.