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Answer 3
  1. Stage IVA. In the clinical scenario described, a tumor size of 2.5 cm is clinically staged as a T3 tumor. Pancreatic and bile duct dilatation is not included in the staging criteria for this disease. Vascular involvement, such as that of the portal vein in this case, is clinically staged as a T4 tumor. Although no information is provided about regional node involvement, T4 disease can be staged as either IVA or IVB. In the absence of demonstrated metastases (stage IVB), this patient’s cancer is best described as stage IVA.

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