Bile duct cancer grading and staging

What are the grades of bile duct cancer?

The grade of a cancer describes the tumour cells and can give your doctors an idea of how quickly it might grow and spread. Low-grade cancers are usually slower growing, and high-grade cancers have a greater risk of spreading.

What are the stages of bile duct cancer?

Staging means finding out how big the cancer is and if it has spread to other parts of your body. Staging will help your doctor to plan the best treatment for you.

The staging system usually used for intrahepatic bile duct cancer and distal extrahepatic bile duct cancer is called TNM. This stands for:

• Tumour (T): The size of the tumour.
• Node (N): Is there cancer in your lymph nodes? N0 means there are no lymph nodes affected.
• Metastasis (M): Has the cancer has spread to other parts of your body? M0 means it hasn’t spread to other parts.

Your doctor often uses this information to give your cancer a number stage – from 1 to 4. Or they may use a number staging system instead of the TNM system. In either case, a higher number, such as stage 4, means a more advanced cancer. 

For perihilar bile duct cancer your doctor may use a staging system called the Bismuth-Corlette staging system. This is based on where exactly in the perihilar area the cancer is situated. For example, type 1 is when the cancer is in the common hepatic duct; type 2 is where it is in the common hepatic duct and also in the area where the left and right hepatic ducts join.