Introduction: Pancreatic adenocarcinoma has a poor prognosis, underscoring the need for accurate staging systems. The 8th edition of the AJCC TNM classification introduced key changes, including size-based T staging and the N2 category for ≥4 positive lymph nodes. This study compares the prognostic value of the 7th and 8th editions. Methods: A retrospective cohort of 214 patients with resected pancreatic adenocarcinoma was analyzed. TNM staging was applied using both editions. Associations with disease progression and overall survival were assessed using chi-square tests and Kaplan-Meier survival analysis. Results: The 8th edition led to significant reclassification, especially within Stage II and Stage III. Both editions showed significant association with disease recurrence. However, only the 7th edition was significantly associated with overall survival. Conclusions: The 8th edition improves disease progression stratification through refined T and N criteria but shows limited ability to predict overall survival compared to the 7th edition. These findings support the use of updated TNM staging while highlighting the need for complementary prognostic tools.

Introduction: Accurate staging is essential in pancreatic adenocarcinoma due to its aggressive nature and poor prognosis. The 8th edition of the AJCC TNM staging system introduced changes in tumor size criteria and nodal classification. This study compares the prognostic performance of the 7th and 8th editions in resected patients. Material and Methods: A retrospective analysis was conducted on 214 patients with pancreatic adenocarcinoma who underwent curative surgery. TNM staging was assigned according to both AJCC editions. Kaplan–Meier analysis and multivariate Cox regression, stratified by adjuvant therapy, were used to assess disease-free survival (DFS) and overall survival (OS). Results: The 8th edition TNM staging was significantly associated with lower risk of recurrence, with TNM stages I and II independently predicting better DFS (p < 0.05). In contrast, the 7th edition TNM stage I remained the only independent predictor of OS (HR = 0.376; p = 0.023). Reclassification between editions altered stage distribution, particularly within stage II. Conclusions: The 8th edition improves early recurrence stratification, while the 7th edition retains stronger prognostic value for overall survival. Both systems offer complementary insights, supporting outcome-specific staging use.