![]() To measure mitosis, the doctor counts the number of dividing cells seen in 2 millimeters squared under a microscope this is called the mitotic index. Grade (G) and degree of differentiationĭoctors also describe a pancreas NET by its grade (G) and degree of differentiation, both features that are determined when the tumor cells are viewed under the microscope.įor NETs, the grade describes how fast the tumor cells are growing and dividing, measured in 2 ways: mitosis and Ki-67. Stage IV: There is distant metastasis (any T, any N, M1). Or, the tumor has spread to the stomach, spleen, colon, or adrenal gland, or the wall of the celiac axis or the superior mesenteric artery, but the cancer has not spread to the regional lymph nodes or anywhere else (T4, N0, M0). Stage III: The tumor is any size and has spread to the regional lymph nodes (any T, N1, M0). Stage II: The tumor is larger and has not spread to the regional lymph nodes or elsewhere in the body (T2 or T3, N0, M0). Stage I: There is a small tumor in the pancreas and it has not spread elsewhere in the body (T1, N0, M0). M1c: The cancer has spread to both nearby and distant parts of the body.ĭoctors combine the T, N, and M information to decide what stage the cancer is. M1b: The cancer has spread to at least 1 area beyond the liver, such as a lung, ovary, a nonregional lymph node, the peritoneum, or a bone. M1a: The cancer has spread only to the liver. M0 (M plus zero): There is no distant spread. The "M" in the TNM system describes whether the cancer has spread to other parts of the body, called metastasis. N1: The cancer has spread to the regional lymph nodes. N0 (N plus zero): The cancer has not spread to the regional lymph nodes. NX: Regional lymph nodes cannot be evaluated. Lymph nodes in other parts of the body are called distant lymph nodes. Lymph nodes near where the cancer started are called regional lymph nodes. These small, bean-shaped organs help fight infection. The "N" in the TNM system stands for lymph nodes. T4: The tumor has grown into the stomach, spleen, colon, or adrenal gland, or the wall of the celiac axis or the superior mesenteric artery, which are large vessels. T3: The tumor is limited to the pancreas and is larger than 4 cm in size, or the tumor is invading the duodenum or bile duct. T2: The tumor is limited to the pancreas and is 2 cm to 4 cm in size. T1: The tumor is limited to the pancreas and is less than 2 cm in size. Specific tumor stage information is listed below. Stages may also be divided into smaller groups that help describe the tumor in even more detail. A centimeter is roughly equal to the width of a standard pen or pencil. ![]() Tumor size is measured in centimeters (cm). For example, a T2(3) would mean that the largest tumor found is T2 size and that there are 3 tumors. If the T is followed by a number in parentheses or the letter “m,” it indicates the number of tumors found or that multiple tumors are found. Using the TNM system, the "T" plus a letter or number (1 to 4) is used to describe the size and location of the tumor. Here are more details on each part of the TNM system for a pancreas NET. The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments. The results are combined to determine the stage of cancer for each person.įor a pancreas NET, there are 4 stages: I through IV (1 through 4). Metastasis (M): Has the cancer spread to other parts of the body? If so, where and how much? Node (N): Has the tumor spread to the lymph nodes? If so, where and how many? Tumor (T): How large is the primary tumor? Where is it located? Doctors use the results from diagnostic tests and scans to answers these questions: TNM staging is usually determined after the tumor is removed by surgery and evaluated by a pathologist. One tool that doctors use to describe the stage is the TNM system. There are different stage descriptions for different types of cancer. This is because a pancreas NET that is smaller than 2 centimeters (cm) has a lower risk of spreading. For example, people with a smaller tumor may not need surgery, while many people with a larger tumor do. Knowing the stage helps the doctor recommend what kind of treatment is best, and it can help predict a patient's prognosis, which is the chance of recovery. Staging is a way of describing where the tumor is located, if or where it has spread, and whether it is affecting other parts of the body.ĭoctors use diagnostic tests and, sometimes, information obtained from surgery, to find out the tumor's stage, so staging may not be complete until all of the tests are finished. In addition, you can read about how doctors describe how fast the tumor cells are growing and dividing, called the grade. ON THIS PAGE: You will learn about how doctors describe a tumor’s growth or spread.
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