Intrahepatic bile duct cancer stages

Bile duct cancer is also known as cholangiocarcinoma. There are different types of bile duct cancer depending on where it starts. Intrahepatic bile duct cancer starts in the bile ducts in the liver.

Diagram showing the position of the intrahepatic bile ducts

There are different ways of staging intrahepatic bile duct cancer. In the UK, doctors usually use the:

number staging system
TNM system

The stage of a cancer tells you how big the cancer is and whether it has spread. This is important because your doctor uses this information to decide which treatment you need. Your doctor looks at your test results to work out the stage.

The number staging system

The number staging system divides intrahepatic bile duct cancer into 4 main stages, from 1 to 4.

Stage 1

Stage 1 means the cancer is only in the bile ducts. It is split into two groups:

Stage 1A means there is only one tumour and it is less than 5cm. It has not grown into any nearby blood vessels or spread anywhere else. This is the same as T1a, N0, M0 in the TNM staging system.

Stage 1B means there is only one tumour and it is bigger than 5cm. It has not grown into any nearby blood vessels. This is the same as T1b, N0, M0.

Stage 2

Stage 2 means there are one or more tumours. It might have grown into nearby blood vessels. This is the same as T2, N0, M0.

Stage 3

Stage 3 is divided into two groups:

Stage 3A means the tumour has grown through the covering of the liver (the visceral peritoneum). This is the same as T3, N0, M0.

Stage 3B means the tumour has grown into nearby structures outside the liver such as the bowel. This is the same as T4, N0, M0.

Or it means the tumour has spread to the nearby lymph nodes. This is the same as Any T, N1, M0.

Stage 4

Stage 4 means that the cancer has spread to other areas of the body such as the lungs. This is the same as Any T, Any N, M1.

The TNM staging system

TNM stands for Tumour, Node and Metastasis. The system describes:

the size of the primary tumour (T)
whether the cancer has spread to the lymph nodes (N)
whether the cancer has spread to another part of the body (M)

Tumour (T) stages

There are 4 main T stages for intrahepatic bile duct cancer, from T1 to T4.

T1 means there is only one tumour. It is split into 2 groups. T1a means the tumour is 5cm or less. T1b means the tumour is bigger than 5cm.

T2 means there are one or more tumours. It might have grown into nearby blood vessels.

T3 means the tumour has grown through the lining covering the liver (the visceral peritoneum).

T4 means the tumour has grown into nearby structures outside the liver, such as the bowel.

Node (N) stages

There are two N stages for intrahepatic bile duct cancer, N0 and N1.

N0 means there are no cancer cells in the lymph nodes.

N1 means there are cancer cells in the lymph nodes.

Metastasis (M) stages

There are two M stages, M0 and M1.

M0 means there is no sign of cancer spread.

M1 means the cancer has spread to other parts of the body, such as the lungs.

Treatment options for intrahepatic bile duct cancer

The stage of the cancer helps your doctor decide which treatment you need. Treatment also depends on:

where the cancer is
your general health and level of fitness

You might have surgery if you have a stage 1 or 2 intrahepatic bile duct cancer. Usually, your surgeon removes part of the liver. This is a major operation. Your doctor will make sure that you are well enough to have it.

Unfortunately, most bile duct cancers are usually advanced by the time they are diagnosed. This means you might not be able to have surgery. Your doctor might suggest other treatments to reduce your symptoms and help you feel better. This includes chemotherapy and putting a small tube (stent) to open up a blockage caused by the cancer.