Key Points for This Section

Tests and procedures to stage gallbladder cancer are usually done at the same time as diagnosis. 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 ¹ section for a description of tests and procedures used to detect, diagnose, and stage gallbladder 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).

Glossary Terms

Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

A tube through which bile passes in and out of the liver.

A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A group of abnormal cells that remain in the tissue in which they first formed. These abnormal cells may become cancer and spread into nearby normal tissue.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.

Supporting tissue that surrounds other tissues and organs. Specialized connective tissue includes bone, cartilage, blood, and fat.

The process of identifying a disease by the signs and symptoms.

The pear-shaped organ found below the liver. Bile is concentrated and stored in the gallbladder.

Cancer that forms in tissues of the gallbladder. The gallbladder is a pear-shaped organ below the liver that collects and stores bile (a fluid made by the liver to digest fat). Gallbladder cancer begins in the innermost layer of tissue and spreads through the outer layers as it grows.

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

The moist, inner lining of some organs and body cavities (such as the nose, mouth, lungs, and stomach). Glands in the mucosa make mucus (a thick, slippery fluid). Also called mucous membrane.

A part of the body that performs a specific function. For example, the heart is an organ.

A glandular organ located in the abdomen. It makes pancreatic juices, which contain enzymes that aid in digestion, and it produces several hormones, including insulin. The pancreas is surrounded by the stomach, intestines, and other organs.

The part of the digestive tract that is located between the stomach and the large intestine.

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 I gallbladder cancer is divided into stages IA and IB. In stage IA, cancer has spread beyond the innermost (mucosal) layer to the connective tissue or to the muscle layer.

Stage I gallbladder cancer is divided into stages IA and IB. In stage IB, cancer has spread beyond the muscle layer to the connective tissue around the muscle.

Stage II gallbladder cancer is divided into stages IIA and IIB. In stage IIA, cancer has spread beyond the 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.

Stage II gallbladder cancer is divided into stages IIA and IIB. In stage IIB, cancer has spread in one of the following ways: (1) beyond the innermost layer to the connective tissue and to nearby lymph nodes; or (2) to the muscle layer and nearby lymph nodes; or (3) beyond the muscle layer to the connective tissue around the muscle and nearby lymph nodes; or (4) through the 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.

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.

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

An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

A group or layer of cells that work together to perform a specific function.

Cancer that has spread to the tissues around the gallbladder (such as the liver, stomach, pancreas, intestine, or lymph nodes in the area) and cannot be surgically removed.

The layers of tissue that cover the outer surface of most organs in the abdomen, including the intestines.