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.