Introduction of 7th AJCC TNM Staging for Hepatobiliary, Pancreatic Ampulla of Vater, Exocrine and Endocrine Cancers

ABSTRACT

The tumor node metastasis (TNM) system, which was developed by the American Joint Committee on Cancer (AJCC), is the most practical cancer staging system available. The AJCC TNM staging has been modified periodically in response to newly acquired clinical information and data on prognosis. The seventh edition of this system was published in late 2009 and the manual is effective for cancers diagnosed during or after 2010. There are 9 new classifications, 6 major modifications, elimination of cMX (metastasis cannot be assessed clinically), and there is an introduction to anatomical stages and prognostic groupings. But, compared to the 6th edition, there are no remarkable changes regarding ampulla of Vater and pancreatic cancer, except that neuroendocrine tumors of the pancreas now is staged as a carcinoma.