Stages of gallbladder cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for gallbladder cancer is the TNM system. For gallbladder cancer there are 5 stages – stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the gallbladder and has not spread to other parts of the body. Regional means close to the gallbladder or around it. Distant means in a part of the body farther from the gallbladder.

Find out more about staging cancer.

Stage 0 (carcinoma in situ)

The tumour is only on the inner lining of the gallbladder. It has not grown into the wall of the gallbladder.

Stage 1A

The tumour has grown into the layer of connective tissue (lamina propria) of the gallbladder.

Stage 1B

The tumour has grown into the muscle layer surrounding the lamina propria.

Stage 2A

The tumour has grown into the connective tissue that covers the muscle layer (perimuscular layer) on the side of the gallbladder next to the liver.

Stage 2B

The tumour has grown into the perimuscular layer on the side of the gallbladder next to the peritoneum.

Stage 3A

The tumour has grown through the outer covering of the gallbladder (serosa) or has grown into the liver or 1 nearby organ.

Stage 3B

The tumour has grown into the gallbladder wall or through the covering and has spread to 1 to 3 nearby lymph nodes.

Stage 4

The cancer has spread to any of the following areas:

  • a main blood vessel (portal vein or hepatic artery), with or without spread to 1 to 3 lymph nodes
  • 2 or more organs outside the gallbladder, with or without spread to 1 to 3 lymph nodes
  • 4 or more nearby lymph nodes
  • parts of the body farther from the gallbladder (called distant metastasis), such as to the lungs

Stage 4 can be divided into stages 4A and 4B based on where the cancer has spread and how many lymph nodes have cancer.

Recurrent gallbladder cancer

Recurrent gallbladder cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

Expert review and references

  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.

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