Staging describes the location of cancer, its spread and the extent to which it has affected other areas of the body. The stage of cancer is determined by doctors using diagnostic tests. Therefore, staging may not be completed until all tests have been completed. The doctor can use this information to determine the best treatment and help predict the patient's chance of success. Different types of cancer have different stages. It is crucial that staging be performed at a hospital with expertise in staging pancreatic carcinoma.
To stage pancreatic carcinoma, doctors use several methods. TNM classification is a method that is used to stage other types of cancer. However, it is often not used for pancreatic carcinoma.
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Pancreatic cancer can be classified in one of these 4 categories. It is based on its ability to be removed surgically and the extent to which it has spread.
Resectable
This type of pancreatic carcinoma can be removed surgically. Surgery can often be performed right after diagnosis. Sometimes additional treatment is necessary before the surgery. It may only be in the pancreas, or it could extend to other areas. However, it has not invaded important arteries and veins. The tumor has not spread beyond the pancreas. This stage is found in approximately 10% to 15% of patients.
Borderline resectable
This is a category that describes a tumor that is difficult or impossible to remove surgically after it is diagnosed. However, if chemotherapy and/or radiotherapy are able to shrink the tumour first, then surgery may be possible later with negative margins. A negative margin is when there are no visible cancer cells left behind.
Locally developed
It is still found in the area surrounding the pancreas. However, it cannot be removed surgically because it has grown into nearby veins, arteries or organs. It cannot be removed surgically as the risk of causing damage to nearby structures is too great. It is not evident that the disease has spread to other parts of the body. This stage is found in approximately 35% to 40% patients.
Metastatic
The tumor has grown beyond the pancreas area and into other organs such as the liver or lungs. This stage is found in approximately 45% to 55% percent of patients.
The health care team can determine the best treatment strategy by classifying every cancer into one of these categories.
TNM Staging System
To stage other types of cancer, doctors often use the TNM system. This system allows doctors to classify tumors during surgery. Many patients with pancreatic carcinoma do not have surgery. The TNM system isn't used for pancreatic cancer in the same way it is used for other types of cancer.
To answer these questions, doctors use scans, diagnostic tests and surgery results for the TNM system.
Tumor (T). How big is the primary tumor? It is located where?
Node (N),: Has the cancer spread to the lymph nodes. If yes, which location and how many?
Metastasis (M),: Has the cancer spread? If yes, how many?
These results are used to determine each person's stage of cancer. There are five stages to cancer: Stage 0 (zero), and Stages I through IV (1 through four). Each stage is a way to describe the cancer in a common language so that doctors can collaborate on the best treatment plans. The TNM system for pancreatic carcinoma is described in detail below.
Tumor (T).
The TNM system uses the “T” plus one letter or number (0-44) to describe the size of the tumor. The size of a tumor is measured in centimeters. One centimeter is approximately equal to one standard pen or pencil's width.
The doctor can use the tumor stage to determine the best treatment plan. Below is information about the specific tumor stages.
TX: It is not possible to evaluate the primary tumor.
T0 (T plus zero),: There was no evidence of cancer in the pancreas.
Tis: This is a term that refers to carcinoma in situ. It is a very early form of cancer that has not spread.
T1: This stage is located in the pancreas and is approximately 2 cm (cm) in size. Based on the size and location of the tumor, this stage can be further divided into three stages: T1a,T1b, or T1c.
T2: The tumor is located in the pancreas and is not greater than 2 cm. It is not larger than 4cm.
T3: A tumor that is greater than 4 cm in size and extends beyond its pancreas. It doesn't affect the major arteries and veins around the pancreas.
T4: A tumor that extends beyond the pancreas and into major veins or arteries near the pancreas. T4 tumors cannot be removed completely by surgery.
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मंचन कैंसर के स्थान, इसके प्रसार और शरीर के अन्य क्षेत्रों को किस हद तक प्रभावित करता है, इसका वर्णन करता है । कैंसर का चरण नैदानिक परीक्षणों का उपयोग करके डॉक्टरों द्वारा निर्धारित किया जाता है । इसलिए, जब तक सभी परीक्षण पूरे नहीं हो जाते, तब तक मंचन पूरा नहीं हो सकता है । डॉक्टर इस जानकारी का उपयोग सर्वोत्तम उपचार निर्धारित करने और रोगी की सफलता की संभावना का अनुमान लगाने में मदद कर सकते हैं । विभिन्न प्रकार के कैंसर के अलग-अलग चरण होते हैं । यह महत्वपूर्ण है कि अग्नाशयी कार्सिनोमा के मंचन में विशेषज्ञता वाले अस्पताल में मंचन किया जाए ।
अग्नाशयी कार्सिनोमा को स्टेज करने के लिए, डॉक्टर कई तरीकों का उपयोग करते हैं । टीएनएम वर्गीकरण एक ऐसी विधि है जिसका उपयोग अन्य प्रकार के कैंसर को स्टेज करने के लिए किया जाता है । हालांकि, यह अक्सर अग्नाशयी कार्सिनोमा के लिए उपयोग नहीं किया जाता है ।
अग्नाशय के कैंसर को इन 4 श्रेणियों में से एक में वर्गीकृत किया जा सकता है । यह शल्य चिकित्सा द्वारा हटाए जाने की क्षमता और यह किस हद तक फैल गया है, इस पर आधारित है ।
Resectable
इस प्रकार के अग्नाशयी कार्सिनोमा को शल्य चिकित्सा द्वारा हटाया जा सकता है । निदान के तुरंत बाद सर्जरी अक्सर की जा सकती है । कभी-कभी सर्जरी से पहले अतिरिक्त उपचार आवश्यक होता है । यह केवल अग्न्याशय में हो सकता है, या यह अन्य क्षेत्रों तक फैल सकता है । हालांकि, इसने महत्वपूर्ण धमनियों और नसों पर आक्रमण नहीं किया है । ट्यूमर अग्न्याशय से परे नहीं फैला है । यह चरण लगभग 10% से 15% रोगियों में पाया जाता है ।
सीमा रेखा resectable
यह एक ऐसी श्रेणी है जो एक ट्यूमर का वर्णन करती है जो निदान होने के बाद शल्य चिकित्सा द्वारा निकालना मुश्किल या असंभव है । हालांकि, अगर कीमोथेरेपी और / या रेडियोथेरेपी पहले ट्यूमर को सिकोड़ने में सक्षम हैं, तो बाद में नकारात्मक मार्जिन के साथ सर्जरी संभव हो सकती है । एक नकारात्मक मार्जिन तब होता है जब कोई दिखाई देने वाली कैंसर कोशिकाएं पीछे नहीं छोड़ी जाती हैं ।
स्थानीय रूप से विकसित
यह अभी भी अग्न्याशय के आसपास के क्षेत्र में पाया जाता है । हालाँकि, इसे शल्य चिकित्सा द्वारा हटाया नहीं जा सकता क्योंकि यह पास की नसों, धमनियों या अंगों में विकसित हो गया है । इसे शल्य चिकित्सा द्वारा हटाया नहीं जा सकता क्योंकि आस-पास की संरचनाओं को नुकसान पहुंचाने का जोखिम बहुत अधिक है । यह स्पष्ट नहीं है कि यह बीमारी शरीर के अन्य हिस्सों में फैल गई है । यह चरण लगभग 35% से 40% रोगियों में पाया जाता है ।
मेटास्टैटिक
ट्यूमर अग्न्याशय क्षेत्र से परे और यकृत या फेफड़ों जैसे अन्य अंगों में बढ़ गया है । यह चरण लगभग 45% से 55% प्रतिशत रोगियों में पाया जाता है ।
स्वास्थ्य देखभाल टीम इन श्रेणियों में से प्रत्येक कैंसर को वर्गीकृत करके सर्वोत्तम उपचार रणनीति निर्धारित कर सकती है ।
