Extrahepatic bile ducts
TNM staging of perihilar bile duct tumors

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 9 February 2018, last major update September 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: TNM staging of perihilar bile duct tumors

Cite this page: Gulwani, H. TNM staging of perihilar bile duct tumors. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/gallbladderstagingextrahepatic.html. Accessed February 24th, 2018.
Definition / general
  • Classification excludes sarcomas and carcinoid tumors
  • Divided into perihilar (proximal) and distal bile duct tumors
Primary tumor (T) - perihilar bile duct tumors
  • TX: Primary tumor cannot be assessed
  • T0: No evidence of primary tumor
  • Tis: Carcinoma in situ
  • T1: Tumor confined to the bile duct, with extension up to the muscle layer or fibrous tissue
  • 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 the second order biliary radicals bilaterally or unilateral second order biliary radicals with contralateral portal vein or hepatic artery involvement
Regional lymph nodes (N) - perihilar bile duct tumors
  • NX: Regional lymph nodes cannot be assessed
  • N0: No regional lymph node metastasis
  • N1: Regional lymph node metastasis (including nodes along the cystic duct, common bile duct, hepatic artery and portal vein)
  • N2: Metastases to periaortic, pericaval, superior mesenteric artery or celiac artery lymph nodes
Distant metastasis (M) - perihilar bile duct tumors
  • M0: No distant metastasis
  • M1: Distant metastasis
Stage grouping - perihilar bile duct tumors
  • 0: Tis N0 M0
  • I: T1 N0 M0
  • II: T2a - b N0 M0
  • IIIA: T3 N0 M0
  • IIIB: T1 - 3 N1 M0
  • IVA: T4 N0 - 1 M0
  • IVB: any T N2 M0 or any T any N M1