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Table 6. Definitions of TNM Stage IVa

Stage TNM Description Illustration 
IVAny T, Any N, M1TX = Primary tumor cannot be assessed.
T0 = No evidence of primary tumor.
Tis = Carcinoma in situ.b
T1 = Tumor limited to the pancreas, ≤2 cm in greatest dimension.
T2 = Tumor limited to the pancreas, >2 cm in greatest dimension.
T3 = Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery.
T4 = Tumor involves the celiac axis or the superior mesenteric artery (unresectable primary tumor).
NX = Regional lymph nodes cannot be assessed.
N0 = No regional lymph node metastasis.
N1 = Regional lymph node metastasis.
M1 = Distant metastasis.

aReprinted with permission from AJCC: Exocrine and endocrine pancreas. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 241-9.
bThis also includes the pancreatic intraepithelial neoplasia (PanIN)-3 classification.