Staging

TNM (Tumour, Node and Metastasis) staging for:

  • Intrahepatic cholangiocarcinoma
  • Hilar (Perihilar) cholangiocarcinoma
  • Extrahepatic/Distal cholangiocarcinoma

Intrahepatic cholangiocarcinoma:

– T stages of intrahepatic cholangiocarcinoma

  • Tis – the tumour is only within the top layers of cells lining the bile duct
  • T1– there is one tumour that is contained within the bile duct, but has grown deeper into the wall of the bile duct
  • T2a – there is one tumour and it has grown through the wall of the bile duct into a nearby blood vessel
  • T2b – there is more than one tumour which may or may not have grown into a nearby blood vessel
  • T3 – the tumour has either grown into the covering of the liver (the peritoneum) or has grown into nearby structures outside the liver, such as the bowel
  • T4 – the tumour has spread into the liver by growing along the ducts

– N stages of intrahepatic cholangiocarcinoma

  • N0 – there are no cancer cells in the lymph nodes
  • N1 – there are cancer cells in the lymph nodes

– M stages of intrahepatic cholangiocarcinoma

  • M0 – there is no sign of cancer spread
  • M1 – the cancer has spread to other parts of the body away from the bile duct

Hilar cholangiocarcinoma

– T stages of hilar cholangiocarcinoma

  • Tis – the tumour is only within the top layers of cells lining the bile duct
  • T1– the tumour has grown deeper into the wall of the bile duct
  • T2a – the tumour has grown through the wall of the bile duct into the fatty tissue around it
  • T2b – the tumour has grown into the main part of the liver next to the bile duct
  • T3 – the tumour has grown into one of the main blood vessels of the liver (the portal vein or hepatic artery)
  • T4 – the tumour has grown into the right and left hepatic bile ducts. Or it has grown into more than one of the blood vessels. Or it has grown into a hepatic bile duct and more than one blood vessel

– N stages of hilar cholangiocarcinoma

  • N0 – there are no cancer cells in the lymph nodes
  • N1 – there are cancer cells in nearby lymph nodes
  • N2 – there are cancer cells in lymph nodes further away, such as the chest

– M stages of hilar cholangiocarcinoma

  • M0 – there is no sign of cancer spread
  • M1 – the cancer has spread to other parts of the body far away from the bile duct

Extrahepatic/Distal Cholangiocarcinoma

– T stages of extrahepatic/distal cholangiocarcinoma

  • Tis – the tumour is only within the top layers of cells lining the bile duct
  • T1– the tumour is entirely inside the bile duct but has grown deeper into the bile duct wall
  • T2 – the tumour has grown through the wall of the bile duct
  • T3 – the tumour has grown into the gallbladder, pancreas, small bowel or other nearby organs
  • T4 – the tumour has grown into the major blood vessel in the abdomen (the aorta) where it joins the main blood vessel of the liver (the hepatic artery)

– N stages of extrahepatic/distal cholangiocarcinoma

  • N0 – there are no cancer cells in the lymph nodes
  • N1 – there are cancer cells in the lymph nodes

– M stages of extrahepatic/distal cholangiocarcinoma

  • M0 – there is no sign of cancer spread
  • M1 – the cancer has spread to other parts of the body away from the bile duct
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