Stage III 
TNM Any T, N1, M0 
The cancer has spread to the regional lymph nodes .

Standard Treatment  There is no reliably curative treatment and no proven adjuvant therapy. The standard palliative treatment options for Stage II and/or clinical trials should be considered.

Three-Year Survival  2 percent 

Investigational 
• Surgery plus radiation therapy with radiosensitizers.
• Intraoperative radiotherapy with and without resection .
• Particle beam radiation therapy if a special research facility is available.

Stage IV 
TNM Any T, any N, M1 
The cancer has spread to distant sites, most commonly the liver or lungs.