Cholangiocarcinoma diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
The staging of cholangiocarcinoma varies depending on whether the tumor is primarily intrahepatic (ICC), hilar/perihilar, or extrahepatic.
Diagnostic Study of Choice
The staging of cholangiocarcinoma varies depending on whether the tumor is primarily intrahepatic (ICC), hilar/perihilar, or extrahepatic.[1][2][3][4]
Staging
Intrahepatic cholangiocarcinoma staging
| Stage | T | N | M |
| IA | T1 | N0 | M0 |
| IB | T2 | N0 | M0 |
| IIA | T3 | N0 | M0 |
| IIB | T1-3 | N1 | M0 |
| III | T4 | Any N | M0 |
| IV | Any T | Any N | M1 |
| AJCC 2010 | |||
| T | Tis | The tumour is only within the top layers of cells lining the bile duct | |
|---|---|---|---|
| T1 | There is one tumor that is contained within the bile duct, but has grown deeper into the wall of the bile duct | ||
| T2a | There is one tumor and it has grown through the wall of the bile duct into a nearby blood vessel | ||
| T2b | There is more than one tumour which may or may not have grown into a nearby blood vessel | ||
| T3 | The tumour has either grown into the covering of the liver (the peritoneum) or has grown into nearby structures outside the liver, such as the bowel | ||
| T4 | The tumour has spread into the liver by growing along the ducts | ||
| N | N0 | There are no cancer cells in the lymph nodes | |
| N1 | There are cancer cells in the lymph nodes | ||
| M | M0 | There is no sign of cancer spread | |
| M1 | The cancer has spread to other parts of the body away from the bile duct | ||
Perhilar cholangiocarcinoma
| Stage | T | N | M |
| IA | T1 | N0 | M0 |
| IB | T2 | N0 | M0 |
| IIA | T3 | N0 | M0 |
| IIB | T1-3 | N1 | M0 |
| III | T4 | Any N | M0 |
| IV | Any T | Any N | M1 |
| AJCC 2010 | |||
| T | Tis | The tumor is only within the top layers of cells lining the bile duct | |
|---|---|---|---|
| T1 | The tumor has grown deeper into the wall of the bile duct | ||
| T2a | The tumor has grown through the wall of the bile duct into the fatty tissue around it | ||
| T2b | The tumor has grown into the main part of the liver next to the bile duct | ||
| T3 | The tumor has grown into one of the main blood vessels of the liver (the portal vein or hepatic artery) | ||
| T4 | The tumour has grown into the right and left hepatic bile ducts. Or it has grown into more than one of the blood vessels. Or it has grown into a hepatic bile duct and more than one blood vessel | ||
| N | N0 | There are no cancer cells in the lymph nodes | |
| N1 | There are cancer cells in nearby lymph nodes | ||
| N2 | There are cancer cells in lymph nodes further away, such as the chest | ||
| M | M0 | There is no sign of cancer spread | |
| M1 | The cancer has spread to other parts of the body far away from the bile duct | ||
Extrahepatic cholangiocarcinoma
| Stage | T | N | M |
| IA | T1 | N0 | M0 |
| IB | T2 | N0 | M0 |
| IIA | T3 | N0 | M0 |
| IIB | T1-3 | N1 | M0 |
| III | T4 | Any N | M0 |
| IV | Any T | Any N | M1 |
| AJCC 2010 | |||
| T | Tis | The tumor is only within the top layers of cells lining the bile duct | |
|---|---|---|---|
| T1 | The tumor is entirely inside the bile duct but has grown deeper into the bile duct wall | ||
| T2 | The tumor has grown through the wall of the bile duct | ||
| T3 | The tumor has grown into the gallbladder, pancreas, small bowel or other nearby organs | ||
| T4 | The tumor has grown into the major blood vessel in the abdomen (the aorta) where it joins the main blood vessel of the liver (the hepatic artery) | ||
| N | N0 | There are no cancer cells in the lymph nodes | |
| N1 | There are cancer cells in the lymph nodes | ||
| M | M0 | There is no sign of cancer spread | |
| M1 | The cancer has spread to other parts of the body away from the bile duct | ||
References
- ↑ Blechacz B, Komuta M, Roskams T, Gores GJ (2011). "Clinical diagnosis and staging of cholangiocarcinoma". Nat Rev Gastroenterol Hepatol. 8 (9): 512–22. doi:10.1038/nrgastro.2011.131. PMC 3331791. PMID 21808282.
- ↑ Patel T (2011). "Cholangiocarcinoma--controversies and challenges". Nat Rev Gastroenterol Hepatol. 8 (4): 189–200. doi:10.1038/nrgastro.2011.20. PMC 3888819. PMID 21460876.
- ↑ Groot Koerkamp B, Wiggers JK, Allen PJ, Busch OR, D'Angelica MI, DeMatteo RP, Fong Y, Gonen M, Gouma DJ, Kingham TP, van Gulik TM, Jarnagin WR (2014). "American Joint Committee on Cancer staging for resected perihilar cholangiocarcinoma: a comparison of the 6th and 7th editions". HPB (Oxford). 16 (12): 1074–82. doi:10.1111/hpb.12320. PMC 4253330. PMID 25267346.
- ↑ Ronnekleiv-Kelly SM, Pawlik TM (2017). "Staging of intrahepatic cholangiocarcinoma". Hepatobiliary Surg Nutr. 6 (1): 35–43. doi:10.21037/hbsn.2016.10.02. PMC 5332207. PMID 28261593.