What are the staging classifications for perihilar bile duct tumors in cholangiocarcinoma (CCC)?

Updated: Dec 28, 2019
  • Author: Peter E Darwin, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Table  2. TNM staging for perihilar bile duct tumors. (Open Table in a new window)

T - Primary tumor

TX

Primary tumor cannot be assessed

T0

No evidence of primary tumor

Tis

Carcinoma in situ – high-grade dysplasia

T1

Tumor confined to the bile duct, with extension up to the muscle layer or fibrous tissue

T2

Tumor invades beyond the wall of the bile duct to surrounding adipose tissue, or tumor invades adjacent hepatic parenchyma

 

T2a

Tumor invades beyond the wall of the bile duct to surrounding adipose tissue

 

T2b

Tumor invades adjacent hepatic parenchyma

T3

Tumor invades unilateral branches of the portal vein or hepatic artery

T4

Tumor invades main portal vein or its branches bilaterally, or the common hepatic artery; or unilateral second-order biliary radicals bilaterally with contralateral portal vein or hepatic artery involvement

N – Regional lymph nodes

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

One to three positive lymph nodes typically involving the hilar, cystic duct, common bile duct, hepatic artery, posterior pancreatoduodenal, and portal vein lymph nodes

N2

Four or more positive lymph nodes from the sites described for N1

M – Distant metastasis

M0

No distant metastasis

M1

Distant metastasis