Stage III should be subclassified into Stage IIIA and IIIB in the American Joint Committee on Cancer (8 th Edition) staging system for pancreatic cancer.

AIM To ascertain the prognostic role of the T4 and N2 category in stage. pancreatic cancer according to the 8th edition of the American Joint Committee on Cancer (AJCC) classification. METHODS Patients were collected from the Surveillance Epidemiology and End Results (SEER) database (2004-2013) and were divided into three groups: T(1-3) N2, T4N(0-1), and T4N2. Overall survival (OS) and disease-specific survival (DSS) of patients were evaluated by the Kaplan-Meier method. RESULTS For the first time, we found a significant difference in OS and DSS between T(1-3)N2/T4N(0-1) and T4N2 but not between T(1-3) N2 and T4N(0-1). A higher grading correlated with a worse prognosis in the T(1-3)N2 and T4N2 groups. CONCLUSION Patients with stage T4N2 had a worse prognosis than those with stage T(1-3)N2/T4N(0-1) in the 8th edition AJCC staging system for pancreatic cancer. We recommend that stage. should be subclassified into stage IIIA [T(1-3) N2/T4N(0-1)] and stage III B (T4N2).