Skip to main content
SpringerLink
Log in

Extrahepatic Bile Ducts

Sarcomas and carcinoid tumors are not included

  • Chapter
AJCC Cancer Staging Manual

Summary of Changes

The T and N classifications have been redefined and simplified.

Invasion of the subepithelial fibro (muscular) connective tissue is classified as T1 irrespective of muscular invasion, which cannot always be noted because of the scarcity of muscle fibers in some bile duct segments.

T2 is defined as invasion beyond the wall of the bile duct.

The T classification allows one to separate locally invasive tumors into resectable (T3) and unresectable (T4).

Invasion of branches of the portal vein (right or left), hepatic artery, or liver is classified as T3.

Invasion of the main portal vein, common hepatic artery, and/or regional organs is classified as T4.

The stage grouping has been changed to allow Stage III to signify locally unresectable disease and Stage IV to indicate metastatic disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Bibliography

  • Albores-Saavedra J, Henson DE: Tumors of the gallbladder and extrahepatic bile ducts. In Atlas of tumor pathology, 2nd series, fascicle 22, Washington, DC: Armed Forces Institute of Pathology, 1986

    Google Scholar 

  • Albores-Saavedra J, Henson DE, Sobin LH: Histological typing of tumours of the gallbladder and extrahepatic bile ducts. In WHO international histological classification of tumors. Berlin: Springer-Verlag, 1991

    Google Scholar 

  • Bhuiya MMR, Nimura Y, Kamiya J, et al: Clinicopathologic factors influencing survival of patients with bile duct carcinoma: multivariate statistical analysis. World J Surg 17:653, 1993

    Article  PubMed  CAS  Google Scholar 

  • Bhuiya MMR, Nimura Y, Kamiya J, et al: Clinicopathologic studies on perineural invasion of bile duct carcinoma. Ann Surg 215:344–349, 1992

    Article  PubMed  CAS  Google Scholar 

  • Braasch JW, Warren KW, Kune GA: Malignant neoplasms of the bile ducts. Surg Clin North Am 47:627–638, 1967

    PubMed  CAS  Google Scholar 

  • Burke EC, Jarnagin WR, Hochwald SN, et al: Hilar cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system. Ann Surg 228:385–394, 1998

    Article  PubMed  CAS  Google Scholar 

  • Hayashi S, Miyazaki M, Kondo Y, et al: Invasive growth patterns of hepatic hilar ductal carcinoma: a histologic analysis of 18 surgical cases. Cancer 73:2922–2929, 1994

    Article  PubMed  CAS  Google Scholar 

  • Henson DE, Albores-Saavedra J, Code D: Carcinoma of the ex-trahepatic bile ducts: histologic types, stage of disease, grade and survival. Cancer 70:1498–1501, 1992

    Article  PubMed  CAS  Google Scholar 

  • Hong SM, Kang GH, Lee HY: Smooth muscle distribution in the extrahepatic bile duct: histologic and immunohisto-chemical studies of 122 cases. Am J Surg Pathol 24:660–667, 2000

    Article  PubMed  CAS  Google Scholar 

  • Kayahara M, Nagakawa T, Tsukioka Y, et al: Neural invasion and nodal involvement in distal bile duct cancer. Hepato-gastroenterology 41:190–194, 1994

    PubMed  CAS  Google Scholar 

  • Kayahara M, Nagakawa T, Ueno K, et al: Lymphatic flow in carcinoma of the distal bile duct based on a clinicopathologic study. Cancer 72:2112–2117, 1993

    Article  PubMed  CAS  Google Scholar 

  • Kosuge T, Yamamoto J, Shimada K, et al: Improved surgical results for hilar cholangiocarcinoma with procedures including major hepatic resection. Ann Surg 230:663–671, 1999

    Article  PubMed  CAS  Google Scholar 

  • Longmire WP Jr, McArthur MS, Bastounis EA, et al: Carcinoma of the extrahepatic biliary tract. Ann Surg 178:333–345,1973

    Article  PubMed  CAS  Google Scholar 

  • Nakeeb A, Pitt HA, Sohn TA, et al: Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 224:463–475, 1996

    Article  PubMed  CAS  Google Scholar 

  • Ogura Y, Takahashi K, Tabata M, et al: Clinicopathological study on carcinoma of the extrahepatic bile duct with special focus on cancer invasion on the surgical margins. World J Surg 18:778–784, 1994

    Article  PubMed  CAS  Google Scholar 

  • Ouchi K, Suzuki M, Hashimoto L, et al: Histologic findings and prognostic factors in carcinoma of the upper bile duct. Am J Surg 157:552–556, 1989

    Article  PubMed  CAS  Google Scholar 

  • Suzuki M, Takahashi T, Ouchi K, et al: The development and extension of hepatohilar bile duct carcinoma: a three-dimensional tumor mapping in the intrahepatic biliary tree visualized with the aid of a graphics computer system. Cancer 64:658–666, 1989

    Article  PubMed  CAS  Google Scholar 

  • Tamada K, Ido K, Ueno N, et al: Preoperative staging of extrahepatic bile duct cancer: comparison with pathological staging. Gastroenterology 100(pt 1):1351–1361, 1991

    Google Scholar 

  • Tio TL, Wijers OB, Sars PR, et al: Preoperative TNM classification of proximal extrahepatic bile duct carcinoma by en-dosonography. Semin Liver Dis 10:114–120, 1990

    Article  PubMed  CAS  Google Scholar 

  • Tompkins RK, Saunders K, Roslyn JJ, et al: Changing patterns in diagnosis and management of bile duct cancer. Ann Surg 211:613–620, 1990

    Google Scholar 

  • Tompkins RK, Thomas D, Wile A, et al: Prognostic factors in bile duct carcinoma. Ann Surg 194:447–455, 1981

    Article  PubMed  CAS  Google Scholar 

  • Tsunodo T, Eto T, Koga M, et al: Early carcinoma of the extrahepatic bile duct. Jpn J Surg 19:691–698, 1989

    Article  Google Scholar 

  • Yamaguchi K: Early bile duct carcinoma. Aust N Z J Surg 62:525–529, 1992

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

    Consortia

    American Joint Committee on Cancer

    Editor information

    Editors and Affiliations

    1. Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA

      Frederick L. Greene M.D. (Chair) (Chair)

    2. Vanderbilt University Medical Center, Nashville, Tennessee, USA

      David L. Page M.D. (Professor of Pathology and Epidemiology) (Professor of Pathology and Epidemiology)

    3. Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA

      Irvin D. Fleming M.D. (Professor) (Professor)

    4. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA

      April G. Fritz C.T.R., R.H.I.T.

    5. The Johns Hopkins School of Medicine, Baltimore, Maryland, USA

      Charles M. Balch M.D. (Professor of Surgery and Oncology) (Professor of Surgery and Oncology)

    6. University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA

      Daniel G. Haller M.D. (Professor of Medicine, Associate Chief for Clinical Affairs) (Professor of Medicine, Associate Chief for Clinical Affairs)

    7. Lynn Sage Breast Center, School of Medicine, Northwestern University, Chicago, Illinois, USA

      Monica Morrow M.D. (Professor of Surgery and Director) (Professor of Surgery and Director)

    Rights and permissions

    Reprints and permissions

    Copyright information

    © 2002 Springer Science+Business Media New York

    About this chapter

    Cite this chapter

    American Joint Committee on Cancer. (2002). Extrahepatic Bile Ducts. In: Greene, F.L., et al. AJCC Cancer Staging Manual. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3656-4_16

    Download citation

    • DOI: https://doi.org/10.1007/978-1-4757-3656-4_16

    • Publisher Name: Springer, New York, NY

    • Print ISBN: 978-3-540-00595-7

    • Online ISBN: 978-1-4757-3656-4

    • eBook Packages: Springer Book Archive

    Publish with us

    Policies and ethics

    Search

    Navigation