Pancreatic Cancer Stages

Stage 0 (carcinoma in situ) of the pancreas

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

Precancerous lesions of the pancreas include:

• high-grade pancreatic intraepithelial neoplasia (PanIn-3)
• intraductal papillary mucinous neoplasm (IPMN) with high-grade dysplasia
• intraductal tubulopapillary neoplasm with high-grade dysplasia
• mucinous cystic neoplasm with high-grade dysplasia

Precancerous lesions have not spread to nearby lymph nodes or to distant parts of the body.

Learn more about treatment for precancerous lesions in the pancreas.

Stage I (1) pancreatic cancer

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

• In stage IA, the tumor is 2 centimeters or smaller.
• In stage IB, the tumor is larger than 2 centimeters but not larger than 4 centimeters.

Stage II (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.

• In stage IIA, the tumor is larger than 4 centimeters.
• In stage IIB, the tumor is any size, and cancer has spread to one to three nearby lymph nodes.

Stage III (3) pancreatic cancer

In stage III, the tumor is any size, and cancer has spread to four or more nearby lymph nodes or to major blood vessels near the pancreas.

Stage IV (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 the blood stream and form tumors in other organs and 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 lung, the cancer cells in the lung are actually pancreatic cancer cells. The disease is called metastatic pancreatic cancer, not lung cancer. Learn more in Metastatic Cancer: When Cancer Spreads.

Resectable, borderline resectable, and unresectable pancreatic cancer

Knowing whether pancreatic cancer can be completely removed by surgery is also important for planning treatment. So, in addition to being assigned a stage, the cancer will be grouped as:

Resectable pancreatic cancer

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

Learn more about treatment for resectable pancreatic cancer.

Borderline resectable pancreatic cancer

Borderline resectable pancreatic cancer has grown into a major blood vessel or nearby tissues. It may be possible to remove the tumor, but there is a high risk that some cancer cells will remain after surgery.

Learn more about treatment for borderline resectable pancreatic cancer.

Locally advanced and metastatic (unresectable) pancreatic cancer

Unresectable pancreatic cancer cannot be removed by surgery because it has grown into major blood vessels, lymph nodes, or spread to other areas and organs of the body. When pancreatic cancer has spread to other areas and organs of the body, it is called metastatic pancreatic cancer. Metastatic pancreatic cancer is not treated with surgery.

Learn more about treatment for locally advanced and metastatic pancreatic cancer.

Recurrent pancreatic cancer

[When Cancer Comes Back
Learn the different types of recurrent cancer and why it returns.](https://www.cancer.gov/types/recurrent-cancer)

Recurrent pancreatic cancer is cancer that has recurred (come back) after it has been treated with surgery or systemic therapy. 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 about treatment for recurrent pancreatic cancer.

Pancreatic tumor grade

Cancer grade describes how abnormal the pancreatic cancer cells look under a microscope and how quickly the cancer cells are likely to grow and spread. Your doctor uses grade and other factors about your cancer, such as its stage, to plan treatment and estimate your prognosis.

• Low-grade pancreatic cancer cells look more like normal cells and tend to grow and spread more slowly than high-grade cancer cells.
• High-grade pancreatic cancer tends to grow and spread more quickly than low-grade pancreatic cancer. High-grade cancers usually have a worse prognosis than low-grade cancers and may need treatment right away or more types of treatment over a longer period.

Learn more about Tumor Grade.

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