Staging

Staging is a process that tells a doctor if a cancer has spread and if it has, how far. There are different staging systems for bile duct cancer, depending on the location of the cancer in the bile ducts:

Staging of Perihilar Bile Duct Cancer

Perihilar bile duct cancers develop at the hilum, or the area just outside of the liver where the left and right hepatic ducts merge together. These tumors may also begin in the common hepatic duct.

Staging of Distal Bile Duct Cancer

Distal bile duct tumors form in the common bile duct, closer to the pancreas and small intestine. These tumors account for about 20-30% of all bile duct cancer diagnoses.

  • Stage 0 - "Carcinoma in situ." Cancer is found in the inner layer of the bile ducts.
  • Stage Ia - Cancer has grown deeper into the wall of the bile duct, but is still confined to the wall.
  • Stage Ib - Cancer has grown through the outer wall of the bile duct.
  • Stage IIa - Cancer has invaded nearby organs or structures (such as the liver, gallbladder, pancreas, and small intestine), but has not invaded any major blood vessels.
  • Stage IIb - Cancer has spread to nearby lymph nodes. It may or may not have grown through the wall and invaded nearby organs.
  • Stage III - Cancer has invaded the major blood vessels that supply the liver, pancreas, stomach, and intestines.
  • Stage IV - Cancer has spread to distant organs or parts of the body.
Staging of Intrahepatic Bile Duct Cancer

Intrahepatic bile duct cancer begins in the small bile duct branches (ductules) inside the liver. These tumors account for about 10% to 20% of all bile duct cancers and about 15% to 20% of all primary liver cancers.

  • Stage 0 - "Carcinoma in situ." Abnormal, but non-invasive cells are found inside the intrahepatic bile ducts.
  • Stage I - A single tumor is found in the intrahepatic bile ducts and no blood vessels are invaded by the tumor.
  • Stage II - A single tumor has grown into nearby blood vessels found in the intrahepatic bile ducts. OR Multiple tumors are found in the intrahepatic bile ducts.
  • Stage III - Tumor has invaded nearby organs and structures, such as the abdominal wall, diaphragm, colon, stomach, or small intestine but not lymph nodes.
  • Stage IVa - Tumor has spread along the intrahepatic bile ducts and is spreading through the liver. OR Cancer has spread to nearby lymph nodes.
  • Stage IVb - Cancer has spread to distant organs or parts of the body.