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Cancer Health Center

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Gallbladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Gallbladder Cancer

Definitions of TNM

The American Joint Committee on Cancer has designated staging by the TNM classification to define gallbladder cancer.[1]

Table 1. Primary Tumor (T)a

a Reprinted with permission from AJCC: Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
TX Primary tumor cannot be assessed.
T0 No evidence of primary tumor.
Tis Carcinoma in situ.
T1 Tumor invades lamina propria or muscular layer.
T1a Tumor invades lamina propria.
T1b Tumor invades muscular layer.
T2 Tumor invades perimuscular connective tissue; no extension beyond serosa or into liver.
T3 Tumor perforates the serosa (visceral peritoneum) and/or directly invades the liver and/or one other adjacent organ or structure, such as the stomach, duodenum, colon, pancreas, omentum, or extrahepatic bile ducts.
T4 Tumor invades main portal vein or hepatic artery or invades at least two extrahepatic organs or structures.

Table 2. Regional Lymph Nodes (N)a

a Reprinted with permission from AJCC: Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
NX Regional lymph nodes cannot be assessed.
N0 No regional lymph node metastasis.
N1 Metastases to nodes along the cystic duct, common bile duct, hepatic artery, and/or portal vein.
N2 Metastases to periaortic, pericaval, superior mesenteric artery, and/or celiac artery lymph nodes.

Table 3. Distant Metastasis (M)a

a Reprinted with permission from AJCC: Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
M0 No distant metastasis.
M1 Distant metastasis.

Table 4. Anatomic Stage/Prognostic Groups

Stage T N M
a Reprinted with permission from AJCC: Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
0 Tis N0 M0
I T1 N0 M0
II T2 N0 M0
IIIA T3 N0 M0
IIIB T1-3 N1 M0
IVA T4 N0-1 M0
IVB Any T N2 M0
Any T Any N M1
1 | 2
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