Key Points for This Section

Tests and procedures to stage gallbladder cancer are usually done at the same time as diagnosis. There are three ways that cancer spreads in the body. The following stages are used for gallbladder cancer: Stage 0 (Carcinoma in Situ) Stage I Stage II Stage III Stage IV For gallbladder cancer, stages are also grouped according to how the cancer may be treated. There are two treatment groups: Localized (Stage I) Unresectable (Stage II, Stage III, and Stage IV)

Tests and procedures to stage gallbladder cancer are usually done at the same time as diagnosis.

See the General Information section for a description of tests and procedures used to detect, diagnose, and stage gallbladder cancer.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

• Through tissue. Cancer invades the surrounding normal tissue.
• Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
• Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

The following stages are used for gallbladder cancer:

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found in the innermost (mucosal) layer of the gallbladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I

In stage I, cancer has formed. Stage I is divided into stage IA and stage IB.

• Stage IA: Cancer has spread beyond the innermost (mucosal) layer to the connective tissue or to the muscle (muscularis) layer.
• Stage IB: Cancer has spread beyond the muscle layer to the connective tissue around the muscle.

Stage II

Stage II is divided into stage IIA and stage IIB.

• Stage IIA: Cancer has spread beyond the visceral peritoneum (tissue that covers the gallbladder) and/or to the liver and/or one nearby organ (such as the stomach, small intestine, colon, pancreas, or bile ducts outside the liver).
• Stage IIB: Cancer has spread:
  • beyond the innermost layer to the connective tissue and to nearby lymph nodes; or
  • to the muscle layer and nearby lymph nodes; or
  • beyond the muscle layer to the connective tissue around the muscle and to nearby lymph nodes; or
  • through the visceral peritoneum (tissue that covers the gallbladder) and/or to the liver and/or to one nearby organ (such as the stomach, small intestine, colon, pancreas, or bile ducts outside the liver), and to nearby lymph nodes.

Stage III

In stage III, cancer has spread to a main blood vessel in the liver or to nearby organs and may have spread to nearby lymph nodes.

Stage IV

In stage IV, cancer has spread to nearby lymph nodes and/or to organs far away from the gallbladder.

For gallbladder cancer, stages are also grouped according to how the cancer may be treated. There are two treatment groups:

Localized (Stage I)

Cancer is found in the wall of the gallbladder and can be completely removed by surgery.

Unresectable (Stage II, Stage III, and Stage IV)

Cancer has spread through the wall of the gallbladder to surrounding tissues or organs or throughout the abdominal cavity. Except in patients whose cancer has spread only to lymph nodes, the cancer is unresectable (cannot be completely removed by surgery).

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