Staging and grading of gallbladder cancer
Staging of gallbladder cancer
The stage of a cancer describes its size and whether it has spread from where it started.
There are different ways of staging cancers. For gallbladder cancer, doctors usually use the TNM staging system and the number staging system.
TNM staging system
TNM stands for tumour, node and metastases:
- T describes the size of the tumour.
- N describes whether the cancer has spread to the lymph nodes and which nodes are involved. For example, N0 means no lymph nodes are affected, while N1 means cancer cells are in the lymph nodes.
- M describes whether the cancer has spread to another part of the body. This is called secondary or metastatic cancer. For example, M0 means the cancer has not spread to other parts of the body.
Number staging system
This staging system uses numbers to describe the stage of the cancer. There are 4 stages of gallbladder cancer:
- Stage 1
The cancer affects only the inner wall of the gallbladder. - Stage 2
The cancer has spread further into the wall of the gallbladder.- Stage 2a is when the cancer has spread further into the wall on the side of the lining of the abdomen (the peritoneum).
- Stage 2b is when the cancer has spread further into the wall on the side of the liver. The cancer has not spread outside the gallbladder to lymph nodes or surrounding organs.
- Stage 3
- Stage 3a is when the cancer has spread to the outer lining of the gallbladder. It may affect an organ that is close by, such as the liver or stomach.
- Stage 3b is when the cancer has spread to lymph nodes close to the gallbladder.
- Stage 4
- Stage 4a is when the cancer has spread to 1 of the main blood vessels of the liver, or to 2 or more nearby organs outside the liver. It may have spread to lymph nodes close to the gallbladder.
- Stage 4b is when the cancer has spread to lymph nodes further away from the gallbladder, or to other parts of the body such as the lungs.
Cancer that has spread to other parts of the body is called secondary cancer or metastatic cancer.
Grading of gallbladder cancer
Grading is about how the cancer cells look under a microscope compared with normal cells:
- Grade 1 (low grade or well differentiated) – the cancer cells look similar to normal cells and usually grow slowly.
- Grade 2 (moderate or intermediate grade) – the cancer cells look more abnormal and are slightly faster-growing.
- Grade 3 (high grade or poorly differentiated) – the cancer cells look very different from normal cells and may grow more quickly.
Related pages
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our gallbladder cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Vogel, A. et al. Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Annals of Oncology. 2022. 34,2; 127-140. Available at: pubmed.ncbi.nlm.nih.gov/36372281/ [accessed March 2023]
Fox, E. Gallbladder Cancer. Medscape. Available at: emedicine.medscape.com/article/278641-overview?form=fpf [accessed April 2023]
Mehrotra, B. Gallbladder cancer: Epidemiology, risk factors, clinical features, and diagnosis. UpToDate. 2022. www.uptodate.com/contents/gallbladder-cancer-epidemiology-risk-factors-clinical-features-and-diagnosis [subscription only; accessed March 2023]
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