Staging of exocrine pancreatic carcinoma

After many years of attempting to stage exocrine pancreatic carcinoma, the fourth edition of the UICC TNM Classification of Tumours is now the international uniform system; it has been accepted by all national TNM committees. The TNM/pTNM-defined stage grouping is complemented by the R classification, which describes the presence or absence of residual tumour following treatment. With this, it is possible to make a good assessment of the prognosis following resection of ductal adenocarcinoma. Multivariate studies must definitively clarify whether additional parameters are of significance for prognosis. A further subdivision of Category pN1 into pN1a (metastasis in single node) and pN1b (two or more nodes) is recommended.