Liver and intrahepatic bile ducts - tumor
TNM staging of intrahepatic bile duct tumors

Author: Deepali Jain, M.D. (see Authors page)

Revised: 6 December 2017, last major update February 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: TNM staging[TIAB] intrahepatic bile duct tumors

Cite this page: Jain, D. TNM staging of intrahepatic bile duct tumors. website. Accessed March 18th, 2018.
Definition / general
  • Includes combined hepatocellular and cholangiocarcinoma
  • Excludes hepatocellular carcinoma, extrahepatic bile duct malignancies
Primary tumor (T)
  • TX: primary tumor cannot be assessed
  • T0: no evidence of primary tumor
  • Tis: carcinoma in situ (intraductal tumor)
  • T1: solitary tumor without vascular invasion
  • T2a: solitary tumor with vascular invasion
  • T2b: multiple tumors, with or without vascular invasion
  • T3: tumor perforating the visceral peritoneum or involving the local extrahepatic structures by direct invasion
  • T4: tumor with periductal invasion

  • Vascular invasion includes gross or microscopic involvement
  • For T3, a major branch means the right or left portal vein or right - middle or left hepatic vein
  • Multiple tumors includes satellitosis, multifocal tumors and intrahepatic metastases
Regional lymph nodes (N)
  • NX: regional lymph nodes cannot be assessed
  • N0: no regional lymph node metastasis
  • N1: regional lymph node metastasis
Distant metastasis (M)
  • M0: no distant metastasis
  • M1: distant metastasis
Stage grouping
  • 0:  Tis N0 M0
  • I:   T1 N0 M0
  • II:  T2 N0 M0
  • III: T3 N0 M0
  • IVA: T4 N0 M0 or any T N1 M0
  • IVB: any T any N M1