Updates in the diagnosis and management of ductal adenocarcinoma of the pancreas

Table 1 T classification in tumor-node-metastasis system for pancreatic ductal adenocarcinoma of American Joint Committee on Cancer 8^th edition

T	Greatest dimension (cm)
Tis	In situ
T1	≤ 2
T1a	≤ 0.5
T1b	> 0.5 and < 1
T1c	1-2
T2	> 2 and ≤ 4
T3	> 4
T4	Involvement of celiac axis, superior mesenteric artery, and/or common hepatic artery

Table 2 Tumor-node-metastasis staging for pancreatic ductal adenocarcinoma of American Joint Committee on Cancer 8^th edition

Stage	Parameters
0	Tis, N0, M0
I
Ia	T1, N0, M0
Ib	T2, N0, M0
II
IIa	T3, N0, M0
IIb	T1-T3, N1, M0
III	Any T, N2, M0 or T4, any N, M0
IV	Any T, any N, M1

T: Tumor invasion; N0: Negative lymph nodes; N1: Positive 1-3 regional lymph nodes; N2: Positive ≥ 4 regional lymph nodes; M0: Without distant metastases; M1: Presence of distant metastases.

Table 3 Predictive factors for favorable prognosis of pancreatic ductal adenocarcinoma

Number	Factor
1	Stage T1-T2
2	Without metastases beyond the pancreas
3	Curative surgical resection
4	R0 resection without infiltration of resection margins
5	G1 (high) cell differentiation or even G2 (moderate); G3 (poor) provides worse outcomes
6	Absence of lymph node infiltration
7	Retrieved lymph nodes > 12
8	Absence of perineural invasion
9	Neoadjuvant systemic treatment in borderline resectable cases, at least
10	Novel adjuvant systemic treatment
11	Absence of early recurrence
12	Without malnutrition and sarcopenia
13	Multimodality treatment