Table 1.
AJCC/UICC-TNM and clinical staging.
| TNM Staging | Clinical Staging | NCCN Criteria of Defining Resectability |
|---|---|---|
| 0 Tis N0 M0 | Resectable | Resectable: No extension into regional arteries (CA, CHA, SMA) or veins (SMV, PV), PV extension to < 180° |
| IA T1 N0 M0 | Resectable | |
| IB T2 N0 M0 | Resectable | |
| IIA T3 N0 M0 | Resectable | |
| IIB T1 N1 M1 T2 N1 M0 T3 N1 M0 |
Resectable | |
| III T4 anyN M0 | Borderline resectable/ locally advanced/ unresectable |
Borderline resectable: Solid tumor contact with -CHA/SMA ≤ 180° -CA ≤ 180° or > 180° with inert aorta and gastroduodenal artery. -SMV/PV > 180° or ≤ 180° with contour irregularity/thrombosis permitting safe reconstruction Or -IVC involvement Unresectable: Solid tumor contact with -CA/SMA > 180° or -CA and aorta engrossment -1st jejunal branch of SMA -Proximal jejunal draining into SMV Or -Tumor involvement or occlusion of SMV/PV rendering it unreconstructible |
| IV AnyT anyN M1 | Unresectable |
CA: Celiac artery; CHA: Common hepatic artery; PV: Portal vein; SMA: Superior mesenteric artery; SMV: Superior mesenteric vein.