Intrahepatic cholangiocarcinoma (staging)

Last revised by Frank Gaillard on 1 Jun 2021

Intrahepatic cholangiocarcinoma staging is conducted most commonly in accordance with the TNM staging classification of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC). As of 2018, the staging criteria are in their 8th edition and reflected below 1. The rare mixed hepatocholangiocarcinoma (combined hepatocellular and cholangiocarcinoma) is also staged according to the intrahepatic bile duct classification 2. However, cancers of the perihilar and distal bile ducts are staged differently.

  • TX: primary tumor cannot be assessed 
  • T0: no evidence of primary tumor
  • Tis: carcinoma in situ (intraductal tumor)
  • T1: solitary tumor without vascular invasion
    • T1a: solitary tumor ≤5 cm without vascular invasion
    • T1b: solitary tumor >5 cm without vascular invasion​
  • T2
    • solitary tumor with intrahepatic vascular invasion or,
    • multiple tumors, with or without vascular invasion​
  • T3: tumor perforating the visceral peritoneum
  • T4: tumor involving local extrahepatic structures by direct invasion
  • NX: regional lymph nodes cannot be assessed
  • N0: no regional lymph node metastasis
  • N1: regional lymph node metastasis present
  • cM0: no evidence of metastases
  • cM1: distant metastasis
  • pM1: distant metastasis, microscopically confirmed
  • stage 0
    • Tis, N0, M0
  • stage IA
    • T1a, N0, M0
  • stage IB
    • T1b, N0, M0
  • stage II
    • T2, N0, M0
  • stage IIIA
    • T3, N0, M0 
  • stage IIIB
    • T4, N0, M0
    • [Any T], N1, M0
  • stage IV
    • [Any T], [Any N], M1

The 5-year survival for each stage of intrahepatic cholangiocarcinoma in the AJCC 8th edition is as follows 3:

  • stage IA: 58%
  • stage IB: 45%
  • stage II: 31%
  • stage IIIA: 24%
  • stage IIIB: 12%
  • stage IV: 9%

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