According to AJCC 8th edition, staging of 2 cm size Pancreatic cancer if it involves portal vein is?
Ans. (a) T1Ref: AJCC 8th edition manual, pg. 340-344AJCC 8th edition has brought the following changes with regard to carcinoma pancreas* T1 is subdivided into T1a, T1b and T1c based on size* T2 and T3 are categorized based on size and not on extra pancreatic involvement anymore* T4 is a radiological staging done by the relationship to vessels* Nodal staging has N1 and N2 subdivisions unlike before N1 aloneTxNo primary tumor could not be assessedNxRegional nodes cannot be assessedT0No evidence of primary tumorN0No regional nodesTisCarcinoma in situ includes Pan-IN 3, IPMN with high-risk features T1Tumor < or =2cm in greatestdimensionT1a - <or = 0.5cmT1b - 0.5 to 1cmT1c - 1.0 to 2.2.0cmN1One to three regional lymph nodesT2Tumor >2cm but < or =4cmN2Four or more lymph nodesT3Tumor >4cm in greatest dimensionM0No distant metastasesT4Tumor any size involvement of celiac axis, superior mesenteric artery and common hepatic arteryM1Distant metastases* Portal vein or SMV involvement will not change the staging as per AJCC 7 and AJCC 8th edition. Staging Decided based on the Tumor size only.* Borderline resectable lesion is lesion involvement >180 degrees of PV/SMV or < 180 degree involvement of Coeliac axis/SMA.
T1
T2
T3
T4
Pancreas