Extrahepatic biliary cancer: New staging classification

Table 6 Distal bile duct tumors (American Joint Commission on Cancer staging 7th edition)

Tumor	TNM classification
T1	Tumor confined to bile duct histologically
T2	Tumor beyond the wall of bile duct
T3	Tumor invades liver, GB, pancreas, but no involvement of celiac axis, or the superior mesenteric artery
T4	Tumor involves the celiac axis, or the superior mesenteric artery
Node
N0	No regional lymph node metastasis
N1	Regional lymph node metastasis (including hilar, celiac, superior mesenteric, periduodenal and peripancreatic)
Metastasis
M0	No distant metastasis
M1	Distant metastasis
Tumor stage	AJCC staging 6th edition
Stage IA	T1, N0, M0
Stage IB	T2, N0, M0
Stage IIA	T3, N0, M0
Stage IIB	T1 or T2 or T3, N1, M0
Stage III	T4, any N, M0
Stage IV	Any T, any N, M1

T: Tumor; N: Node; M: Metastases; GB: Gallbladder; PV: Pulmonary vein; AJCC: American Joint Commission on Cancer.