Our doctors use a variety of diagnostic tests to evaluate gallbladder cancer and develop an individualized treatment plan. If you have been recently diagnosed, we will review your pathology to confirm you have received the correct diagnosis and staging information and develop a personalized treatment plan. If you have a recurrence, we will perform comprehensive testing and identify a treatment approach tailored to your needs.

The staging guidelines developed by the American Joint Committee on Cancer (AJCC) are often used to stage the disease and allow doctors to communicate important information about the cancer with one another in a standardized way. Gallbladder cancer stages are based on three categories:

T (tumor): This describes the size of the original tumor.

N (node): This indicates whether the cancer is present in the lymph nodes.

M (metastasis): This refers to whether cancer has spread to other parts of the body.

Once the TNM scores have been assigned, the cancer is diagnosed at one of these stages:

Stage 0: The cancer is small and found only in the innermost (epithelial) layer of the gallbladder. It has not spread to the lymph nodes or other places in the body.

Stage I (stage 1 gallbladder cancer): Still localized within the gallbladder, the tumor has begun to penetrate into the second and third layers of the gallbladder (the lamina propria and the muscle layer).

Stage II (stage 2 gallbladder cancer): The cancer is still localized within the gallbladder but has now penetrated the deeper layer of perimuscular fibrous tissue. It has not spread to nearby lymph nodes or other organs.

Stage III (stage 3 gallbladder cancer): This stage is divided into two subcategories:

• Stage IIIA: The cancer has extended through the outermost layer of the gallbladder (the serosa), and/or may have extended into the liver or another nearby structure. However, it has not spread to nearby lymph nodes or more distant organs.
• Stage IIIB: Cancer cells have spread to nearby lymph nodes, but the tumor has not spread into the blood vessels leading to the liver, or more than one nearby organ other than the liver. The cancer has also not reached distant organs.

Stage IV (stage 4 gallbladder cancer): This stage is divided into two subcategories:

• Stage IVA: The cancer has spread into the blood vessels leading to the liver, and/or has extended to a nearby organ other than the liver. Cancer cells may have reached nearby lymph nodes, but they have not reached distant organs.
• Stage IVB: Cancers at this stage are the most advanced. Cancer cells have either spread to lymph nodes farther away from the gallbladder, or they have spread to distant organs.

Next topic: How is gallbladder cancer diagnosed?