Stages of Pancreatic Cancer

Cancer stage describes the extent of cancer in the body, such as the size of the tumor, whether it has spread, and how far it has spread from where it first formed. It is important to know the stage of the pancreatic cancer to plan the best treatment.  

There are several staging systems for cancer that describe the extent of the cancer. Pancreatic cancer staging usually uses the TNM staging system. You may see your cancer described by this staging system in your pathology report. Based on the TNM results, a stage (I, II, III, or IV, also written as 1, 2, 3, or 4) is assigned to your cancer. When talking to you about your cancer, your doctor may describe it as one of these stages. 

To learn how doctors stage pancreatic cancer, see tests to diagnose and stage pancreatic cancer. Learn more about Cancer Staging.

The information in this section is about staging for exocrine pancreatic cancer, the most common type of pancreatic cancer.

The following stages are used for pancreatic cancer:

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I (also called stage 1) pancreatic cancer

In stage I, cancer has formed and is found in the pancreas only. Stage I is divided into stages IA and IB, depending on the size of the tumor.

• Stage IA: The tumor is 2 centimeters or smaller.
• Stage IB: The tumor is larger than 2 centimeters but not larger than 4 centimeters.

Stage II (also called stage 2) pancreatic cancer

Stage II is divided into stages IIA and IIB, depending on the size of the tumor and where the cancer has spread.

• Stage IIA: The tumor is larger than 4 centimeters.
• Stage IIB: The tumor is any size, and cancer has spread to 1 to 3 nearby lymph nodes.

Stage III (also called stage 3) pancreatic cancer

In stage III, the tumor is any size, and cancer has spread to:

• four or more nearby lymph nodes; or
• the major blood vessels near the pancreas.

Stage IV (also called stage 4) pancreatic cancer

In stage IV, the tumor is any size, and cancer has spread to other parts of the body, such as the liver, lung, or peritoneal cavity (the body cavity that contains most of the organs in the abdomen).

Stage IV pancreatic cancer is also called metastatic pancreatic cancer. Metastatic cancer happens when cancer cells travel through the lymphatic system or blood and form tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are actually pancreatic cancer cells. The disease is called metastatic pancreatic cancer, not liver cancer. Learn more in Metastatic Cancer: When Cancer Spreads.

The following groups are used to plan treatment:

Resectable pancreatic cancer

Resectable pancreatic cancer can be removed by surgery because it has not grown into important blood vessels near the tumor.

Borderline resectable pancreatic cancer

Borderline resectable pancreatic cancer has grown into a major blood vessel or nearby tissue or organs. It may be possible to remove the tumor, but there is a high risk that all of the cancer cells will not be removed with surgery.

Locally advanced pancreatic cancer

Locally advanced pancreatic cancer has grown into or close to nearby lymph nodes or blood vessels, so surgery cannot completely remove the cancer.

Metastatic pancreatic cancer

Metastatic pancreatic cancer has spread to other organs, so surgery cannot completely remove the cancer.

Recurrent pancreatic cancer

Recurrent pancreatic cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the pancreas or in other parts of the body. Tests will be done to help determine where the cancer has returned in your body. The type of treatment for recurrent pancreatic cancer will depend on where it has come back.

Learn more in Recurrent Cancer: When Cancer Comes Back. Information to help you cope and talk with your health care team can be found in the booklet When Cancer Returns.