Stages of Pancreatic Cancer

After being diagnosed with pancreatic cancer, our expert pathologists at Dana-Farber Brigham Cancer Center will determine your stage of cancer. The stage of cancer describes how much and far the cancer has spread in your body. It is one of the most important things to know when deciding how to best treat your cancer, including whether your cancer can be removed (resected) with surgery. You may need additional diagnostic tests to help our team formally assign a stage to your cancer, which is dependent upon the size and spread of the cancer.

The following clinical staging is commonly used for pancreatic cancer. This staging is especially helpful upon immediate diagnosis since we might not know if the cancer has spread to nearby lymph nodes at that time:

  • Resectable: This stage of cancer is only inside the pancreas. The tumor can be any size, and there is no vascular involvement.
  • Borderline Resectable: These tumors may be any size and has not spread to other parts of the body but involves blood vessels near the pancreas. Surgery to remove the tumor would likely result in positive surgical margins, or damage to the vessels.
  • Locally Advanced: These tumors are localized but with more extensive vascular involvement, meaning it has spread to more nearby tissues, organs, lymph nodes or major blood vessels, especially the arteries near the pancreas. It is non-metastatic, though, meaning it has not spread to organs in other parts of the body.
  • Metastatic: This stage of cancer has spread to organs in other parts of the body, farther away from the pancreas, such as the liver, inner lining of the abdomen (the peritoneum), lungs or bones.

Additionally, below is the AJCC (American Joint Committee on Cancer) TNM staging system (Stages 0–IV), which is also commonly used for pancreatic cancer. A higher number, such as stage IV, means a more advanced cancer.

Stages of Pancreatic Cancer

Stage 0

Also known as pancreatic cancer (or carcinoma) in situ, this stage of cancer is only found in the lining of the pancreas.

Stage I

Also known as resectable cancer, this stage of cancer is only inside the pancreas.

  • Stage IA: The tumor is less than two centimeters across (in diameter).
  • Stage IB: The tumor is greater than two centimeters in diameter, but less than four centimeters.
Stage II

Also known as borderline resectable cancer, this stage of cancer has grown, but has not spread to organs in other parts of the body.

  • Stage IIA: The tumor is more than four centimeters across. It may have grown outside of the pancreas to nearby tissue and organs, but not to nearby lymph nodes, major blood vessels and nerves or organs in other parts of the body (distant sites).
  • Stage IIB: The cancer could be of any size and has spread to no more than three nearby lymph nodes, but not to major blood vessels or organs in other parts of the body.
Stage III

This stage of cancer could be of any size and has either spread to four or more nearby lymph nodes or into nearby major blood vessels with or without spreading into any nearby lymph nodes. The cancer has not spread to organs in other parts of the body.

Stage IV

Also known as metastatic cancer, this stage of cancer has spread to organs in other parts of the body, farther away from the pancreas, such as the liver, inner lining of the abdomen (the peritoneum), lungs or bones.

Learn more about the stages of pancreatic cancer.

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