Javascript er ikke aktivert i din nettleser. Dette er nødvendig for å bruke Oncolex. Kontakt din systemadministrator for å aktivere JavaScript.

Staging of bile duct/gallbladder cancer

The TNM classification is used to determine the stage for bile duct/bladder cancer. The TNM system assesses the tumor (T), lymph nodes (N), and metastasis (M) at the time of diagnosis.

The TNM classification distinguishes between the clinical classification (TNM) and the pathology classification (pTNM).

Bile duct

This classification applies to extrahepatic bile ducts and carcinomas in the main bile ducts.

Primary tumor (T)

  • TX   Primary tumor cannot be assessed
  • T0   No evidence of primary tumor
  • Tis  Carcinoma in situ

 

  • T1   Tumor confined to the wall of the bile duct
  • T2   Tumor invades beyond the wall of the bile duct 

  

  • T3   Tumor infiltrates the liver, gallbladder, pancreas or unilateral branches of the portal vein or hepatic artery.
  • T4   Tumor infiltrates the main portal vein or one of the branches bilaterally, the common hepatic artery or other adjacent structures such as the colon, stomach, duodenum, or abdominal wall.

Regional lymph nodes (N)

  • NX   Regional lymph nodes cannot be assessed
  • N0   No regional lymph node metastasis 
  • N1   Regional lymph node metastasis

Gallbladder

This classification applies only to carcinomas.

Primary tumor (T)

  • TX   Primary tumor cannot be assessed
  • T0   No evidence of primary tumor
  • Tis  Carcinoma in situ

 

  • T1  Tumor invades lamina propria or muscle layer
    • T1a   Tumor invades lamina propria
    • T1b   Tumor invades muscle layer
  • T2   Tumor invades perimuscular connective tissue, no extension beyond serosa or into liver 

 

  • T3   Tumor perforates serosa and/or directly invades the liver and/or other adjacent organ or structure such as the stomach, duodenum, colon, pancreas, omentum, or extrahepatic bile ducts.  
  • T4   Tumor infiltrates the main portal vein or hepatic artery, or invades two or more extrahepatic organs or structures. 

Regional lymph nodes (N)

  • NX   Regional lymph nodes cannot be assessed 
  • N0   No regional lymph node metastasis
  • N1   Regional lymph nodes metastasis 

 

Common stage divisions for gallbladder cancer

Stage I

Stage II

Stage III

Stage IV

 

A

B

Tis

Carcinoma in situ

T1 N0 M0(T1a)

Mucosal lesion

T2 N0 M0 (T1b)

Growth into muscle tissue, but not through serosa   

  

T3 N0 M0

Growth through serosa, invasion of liver < 2 cm, or

T1–T3 N1 M0

Lymph node metastasis to hepatoduodenal ligament

T4 N0–N1 M0

Invasion of liver > 2 cm with or without lymph node metastasis

 

 

 

T1–T4 N2 M0

Lymph node metastasis outside hepatoduodenal ligament or

T1–T4 N0–2

M1 metastasis

 

 

 

Oslo University Hospital shall not be liable for any loss whether direct, indirect, incidental or consequential, arising out of access to, use of, or reliance upon any of the content on this website. Oslo University Hospital© 2016