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

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Liver and intrahepatic bile ducts - tumor

Miscellaneous

TNM staging of Intrahepatic bile duct tumors

Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.

General
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● Includes combined hepatocellular and cholangiocarcinoma
● Excludes hepatocellular carcinoma, extrahepatic bile duct malignancies

Primary tumor (T)
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● 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

Notes:
● 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)
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● NX: regional lymph nodes cannot be assessed
● N0: no regional lymph node metastasis
● N1: regional lymph node metastasis

Distant metastasis (M)
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● M0: no distant metastasis
● M1: distant metastasis

Stage grouping
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● 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

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