About bile duct cancer stages and grades

The stage of a cancer tells you how far it has grown or spread. This is important because your specialist uses this information to decide which treatment is most suitable for you.

Your scans will give some information about the stage of your cancer. 

There are different ways of staging cancer. For bile duct cancer there is a number system and the TNM system. TNM stands for Tumour, Node, Metastasis.

The staging systems are different depending on where the cancer in the bile duct began. These include:

  • bile ducts inside the liver (intrahepatic bile ducts)
  • bile ducts just outside the liver (perihilar bile ducts)
  • the bile ducts nearest to the bowel (distal bile ducts)
Diagram showing the groups of bile ducts

Number staging system

This divides bile duct cancers into 4 main groups:

Stage 1

This means the cancer is small and only in one area of the bile duct (localised cancer).

Stage 2 and 3

This means the cancer is larger, may have grown into the surrounding tissues, and there may be cancer cells in nearby lymph nodes (locally advanced cancer).

Find out about lymph nodes and the lymphatic system

Stage 4

This means the cancer has spread to another part of the body (secondary or metastatic cancer).

TNM stages

The TNM staging system stands for Tumour, Node, Metastasis.

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

The doctor gives each factor (T,N and M) a number, depending on how far the cancer has grown.

So, a very small cancer which hasn't spread to the lymph nodes or elsewhere in the body may be T1 N0 M0.

A larger cancer that has spread into the lymph nodes and to another part of the body may be T3 N1 M1.

Last reviewed: 
05 Jan 2021
Next review due: 
05 Jan 2024
  • AJCC Cancer Staging Manual (8th Edition)
    American Joint Committee on Cancer
    Springer, 2017.

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