Gallbladder cancer as the name suggests, begins in the gallbladder, an organ that stores a substance called bile. To read about gallbladder and gallbladder cancer, click here
How is gallbladder cancer staged?
Staging of gallbladder cancer helps the doctors figure out the on how much the cancer has spread in the body and determine its best treatment. Staging also helps calculate survival statistics too. The lower the number of the stage, the less is the cancer has spread, with early stages being 1 and the most advanced stage being 4. The staging system and the other factors taken into consideration to determine the stage of gallbladder cancer are as follows:
Cancer types that form tumours are staged using TNM system and the same method is used for gallbladder cancer too, TNM stands for stands for tumour, node and metastasis.
Tumour(T) generally is used to categorize the size of the primary tumour but in this case, it used to reflect the extent to which the cancer has spread to the walls of the gallbladder. The gallbladder has several layers listed below in the order of innermost to the outermost layers:
- The epithelium, a thin layer of cells that lines the interior wall of the gallbladder.
- The lamina propria, a layer of loose connective tissues.
- The muscularis, a layer of muscular tissue that helps the gallbladder contract to push the bile into the bile duct.
- The perimuscular, a layer lining the muscularis made up of fibrous tissue.
- The serosa which forms the outer covering of gallbladder and comes from the peritoneum (lining of the abdominal cavity).
The node describes whether the cancer has spread to the nearby lymph nodes or not. N0 represents no spreading of the cancer to the lymph nodes, N1 represents the spreading of cancer to nearby lymph nodes and N2 stands for spreading to distant lymph nodes.
This gives information about the cancer spreading to other parts of the body, M0 represents no metastasis while M1 stands for metastasized tumours.
Read more about the staging of gallbladder cancer here.
Stage III gallbladder cancer:
Stage III of gallbladder cancer is further divided into two stages:
Stage IIIA: The cancer has grown through the serosa and has spread to the liver or nearby structures like the stomach, duodenum, colon, pancreas or bile ducts outside the liver but has not spread to nearby lymph nodes or distant organs and the staging is (T3, N0, M0).
Stage IIIB: The cancer may or may not have spread beyond the gallbladder into the nearby structures but has not grown into the main blood vessels. It has spread to no more than three nearby lymph nodes but has not spread to distant organs and the staging is (TX, N1, M0) where X can be 1, 2 or 3.
How is stage III gallbladder cancer treated?
Surgery was not a treatment option for stage III gallbladder cancer until recently due to advanced and radical surgical methods. Read more about surgery for gallbladder cancer treatment here: It can however increase the patient’s survival if not cure the cancer. Surgery followed by chemotherapy or clinical trials may be the patient’s other options as the cancer is advanced at this stage.
This involves removal of the gallbladder, an inch or more of the liver tissue next to the gallbladder and all the lymph nodes in the region, depending on the spread of the cancer and the patient’s health, removal of surrounding organs or parts such as the follows may be required too:
- Part of the liver, a wedge-shaped section close to the gallbladder (wedge resection) or a whole lobe of the liver (hepatic lobectomy)
- The common bile duct
- Removal of a portion or the entire ligament between the liver and the intestines
- Lymph nodes near the pancreas and major blood vessels
- The pancreas
- The duodenum
Chemotherapy uses drugs to kill cancer cells throughout the body and is used in treating stage III gallbladder cancer if there is a chance of recurrence or the cancer has spread too much and is generally recommended after surgery to destroy remaining cancer cells in this cancer type. Read more about use of chemotherapy in gallbladder cancer treatment here