Stages of intrahepatic bile duct cancer | Cancer Research UK
Cancer Research UK on Google+ Cancer Research UK on Facebook Cancer Research UK on Twitter

Stages of intrahepatic bile duct cancer

Landing page cancer type image

This page has detailed information about the staging systems for intrahepatic bile duct cancer. The bile duct cancer stages page has simpler information. There are separate pages about perihilar bile duct cancer stages and distal bile duct cancer stages

On this page you can find the following information

 

A quick guide to what's on this page

Intrahepatic bile duct cancers start in the bile ducts inside the liver. You may also hear bile duct cancer called cholangiocarcinoma.

What is staging

The stage of a cancer means how big it is, whether it has spread into the lymph nodes, or elsewhere in the body. The tests and scans you have to diagnose your cancer will give some information about the stage. But it may not be possible to be completely sure until you have had an operation.

Knowing the stage is important because your specialist uses this information to decide about the most suitable treatment for you.

Different staging systems

Doctors use 2 different staging systems – the TNM staging system and the number staging system.

TNM staging covers the size of the tumour (T), whether cancer cells have spread into the lymph nodes (N) and whether the tumour has spread anywhere else in the body (M).

The number staging system uses information from the TNM staging system to divide intrahepatic bile duct cancers into one of 4 groups – stages 1 to 4.  Stage 1 is a small, localised cancer and stage 4 means the cancer has spread to another part of the body.

Staging your cancer is an important part of preparation for surgery. If your cancer has spread to another part of your body your doctor needs to know where it has spread to. In this situation they may not need to know exactly what size the cancer in the bile duct is or whether the cancer has spread to any lymph nodes.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating bile duct cancer section.

 

 

What staging is

Intrahepatic bile duct cancers start in the bile ducts inside the liver. You may also hear bile duct cancer called cholangiocarcinoma. The stage means how far the cancer has grown or spread. This is important, because doctors often use this information to decide on the most suitable treatment for you. The tests and scans you have when diagnosing your cancer give your doctor some information about the stage.

Staging your cancer is an important part of preparation for surgery. If your cancer has spread to another part of your body, your doctor needs to know where it has spread to. In this situation they may not need to know exactly what size the cancer in the bile duct is or whether it has spread to any lymph nodes.

You may also hear your doctor talk about the grade of the cancer. Grade is a guide to how fast the cancer is likely to grow. A low grade tumour is generally slow growing and high grade tumours are generally faster growing.

 

The different staging systems

There are different ways of staging cancers. The two main ways are the TNM system and number system.

The information you get about the stage of your cancer may sound a bit confusing. You will probably not be familiar with the terms your doctor uses. If you don't understand what stage your cancer is, and would like to know more, ask your doctor or nurse.

Knowing the stage of your cancer may help you understand why your doctors have chosen a particular treatment for you. At the end of this section there is a list of questions for your doctor that may help. There is more general information about staging cancers in the section on cancers in general.

 

TNM staging

TNM stands for Tumour, Node and Metastasis. The system describes

T stages of intrahepatic bile duct cancer

  • 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 bile duct cancer

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

M stages of intrahepatic bile duct cancer

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

Number stages of intrahepatic bile duct cancer

There are 4 main number stages of intrahepatic bile duct cancer.

Stage 1 means there is only one tumour and it is completely inside the bile duct

Stage 2 means one of the following  

  • There is one tumour and it has grown into a nearby blood vessel
  • There is more than one tumour which may or may not have grown into a nearby blood vessel

Stage 3 means the tumour has either grown into the covering of the liver (the peritoneum) or it has grown into nearby structures outside the liver such as the bowel.

Stage 4 means that the cancer is advanced. There are 2 main groups within stage 4 cancer

  • Stage 4a means the tumour has grown around the bile duct and may have spread along the duct but is not in the lymph nodes. Or the tumour is any size and  there are cancer cells in the lymph nodes but it hasn’t spread any further
  • Stage 4b means that the cancer has spread to another part of the body, away from the bile ducts
 

Grades of intrahepatic bile duct cancer

The grade of a cancer is a way of measuring how abnormal cancer cells are compared to healthy cells. It also gives an idea of how quickly a cancer may grow and whether it is likely to spread.

Low grade cancers are usually slower growing and less likely to spread. High grade cancers tend to be faster growing and more likely to spread. There are 4 grades of intrahepatic bile duct cancer.

Grade 1 cancer means the cancer cells look very like normal bile duct cells. This is called low grade cancer.

Grade 2 cancer means the cancer cells look a bit abnormal. This is called intermediate grade cancer.

Grade 3 cancer means the cancer cells look abnormal and unlike normal bile duct cells. This is called high grade cancer.

Grade 4 cancer means the cancer cells look very abnormal and completely different to normal bile duct cancer cells. This is also called high grade cancer.

Differentiation means how developed or mature a cell is. Cancer cells are not as mature as normal cells. So you may hear your doctor describe grade 1 cancer cells as well differentiated. Grade 2 cancer cells are moderately differentiated. Grade 3 cancer cells are poorly differentiated. Grade 4 cancer cells are undifferentiated.

 

Rate this page:
Submit rating

 

Rated 5 out of 5 based on 7 votes
Rate this page
Rate this page for no comments box
Please enter feedback to continue submitting
Send feedback
Question about cancer? Contact our information nurse team

No Error

Updated: 20 January 2015