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Cancer Health Center

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Extrahepatic Bile Duct Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Stages of Extrahepatic Bile Duct Cancer


The metastatic tumor is the same type of cancer as the primary tumor. For example, if extrahepatic bile duct cancer spreads to the liver, the cancer cells in the liver are actually extrahepatic bile duct cancer cells. The disease is metastatic extrahepatic bile duct cancer, not liver cancer.

There are two staging systems for extrahepatic bile duct cancer.

Extrahepatic bile duct cancer has two staging systems. The staging system used depends on where in the extrahepatic bile duct the cancer first formed.

  • Perihilar or proximal extrahepatic bile duct tumors (perihilar bile duct tumors) form in the area where the bile duct leaves the liver. This type of tumor is also called a Klatskin tumor.
    Klatskin tumor. A tumor that forms in the common hepatic duct, the area where the right and left hepatic duct meet.
  • Distal extrahepatic bile duct tumors (distal bile duct tumors) form in the area where the bile duct empties into the small intestine.

The following stages are used for perihilar extrahepatic bile duct cancer:

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found in the innermost layer of tissue lining the perihilar bile duct. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I

In stage I, cancer has formed in the innermost layer of the wall of the perihilar bile duct and has spread into the muscle and fibrous tissue of the wall.

Stage II

In stage II, cancer has spread through the wall of the perihilar bile duct to nearby fatty tissue or to the liver.

Stage III

Stage III is divided into stages IIIA and IIIB.

  • Stage IIIA: The tumor has spread to one branch of the hepatic artery or of the portal vein.
  • Stage IIIB: The tumor has spread to nearby lymph nodes. Cancer has also spread into the wall of the perihilar bile duct and may have spread through the wall to nearby fatty tissue, the liver, or to one branch of the hepatic artery or of the portal vein.
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