NCCN Guidelines for Patients® | Pancreatic Cancer - page 22

NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2014
Tests for pancreatic cancer
Cancer staging
Cancer staging
The cancer stage is a rating by your doctors of how far the
cancer has grown and spread. Which treatment is best for
you depends on how far the cancer has spread. There are
two ways that may be used to stage or classify pancreatic
cancer. The AJCC (
ommittee on
system groups pancreatic cancer into five stages (stage
0 – stage IV). The stages are defined by the growth of the
primary tumor and its spread to other sites in the body.
In the AJCC system, cancer may be staged twice—once
based on tests before surgery and then based on tests
of tissue removed during surgery. Some doctors use this
staging system to plan treatment.
However, most NCCN doctors do not use the AJCC
staging system. Rather, they classify pancreatic cancer
and plan treatment based on the results of imaging
and other tests done before surgery. In this system,
doctors classify pancreatic cancer into four main groups:
resectable, borderline resectable, locally advanced
unresectable, and metastatic. Because this is the system
most NCCN doctors use, recommendations in the
Treatment guide
in Part 5 are based on this system and
its four groups of pancreatic cancer:
Cancer that has not spread outside the
pancreas and appears to be easily treated
with surgery.
Borderline resectable
Cancer that is confined to the pancreas
but approaches nearby structures or is
accompanied by severe symptoms, raising
concern that the cancer might not be
resectable with clear margins.
Locally advanced unresectable
Cancer that has spread outside the pancreas
to nearby blood vessels or other tissues and
cannot be treated with surgery.
Cancer that has spread outside the pancreas
to organs and tissues far away in the body.
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