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