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Gallbladder cancer

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Staging gallbladder cancer

Staging is a way of describing or classifying a cancer based on the extent of cancer in the body. Extent includes the size of the tumour and where the cancer is in the body. The cancer may grow into the wall of the gallbladder and spread into nearby organs and lymph nodes or other parts of the body. Your healthcare team uses the stage to plan treatment and estimate your prognosis.

The most common staging system for gallbladder cancer is the TNM system. Each stage is given a number from 0 to 4. Stages 1 to 4 are usually given as the Roman numerals I, II, III and IV. Generally, the higher the number, the more the cancer has spread.

When describing the stage, doctors may use the terms local, regional and distant. Local means that the cancer is only in the gallbladder and has not spread to other parts of the body. Regional means close to or around the gallbladder. Distant means in a part of the body farther from the gallbladder.

TNM descriptions

T describes where the primary tumour has grown into the gallbladder wall and other tissues around the gallbladder. T is usually given as a number from 0 to 4. A higher number means that the tumour has grown farther into nearby tissues.

 

N describes whether or not cancer has spread to lymph nodes around the gallbladder. N0 means the cancer hasn’t spread to the lymph nodes. N1 means cancer has spread to the lymph nodes.

 

M describes whether or not the cancer has spread (metastasized) to other parts of the body. M0 means that cancer has not spread to other parts of the body. M1 means that it has spread to other parts of the body.

Stage 0 (or carcinoma in situ)
TNMDescription

Tis

N0

M0

Cancer is found only on the innermost surface of the gallbladder, without growing into the wall.

Stage I
TNMDescription

T1a or T1b

N0

M0

The tumour has grown into the wall of the gallbladder (lamina propria or the muscular layer).

Stage II
TNMDescription

T2

N0

M0

The tumour has grown into the perimuscular layer (connective tissue that covers the muscular layer).

Stage IIIA
TNMDescription

T3

N0

M0

The tumour has grown through the outer surface of the gallbladder (serosa) or has spread to the liver or one other nearby organ.

Stage IIIB
TNMDescription

T1, T2 or T3

N1

M0

The tumour has grown through the outer surface of the gallbladder (serosa) or has spread to the liver or one other nearby organ. It has also spread to nearby lymph nodes.

Stage IVA
TNMDescription

T4

Any N

M0

The tumour has spread to a main blood vessel leading to the liver or to 2 or more nearby organs other than the liver.

The cancer may or may not have spread to nearby lymph nodes.

Stage IVB
TNMDescription

any T

any N

M1

The cancer has spread to organs far away from the gallbladder. The cancer may or may not have spread to nearby lymph nodes.

Recurrent gallbladder cancer

Recurrent gallbladder cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to the primary tumour, it’s called regional recurrence. It can also recur in another part of the body, which is called a distant metastasis, or a a distant recurrence.

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