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Bile Duct Cancer Stages

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Last updated and reviewed on: August 20, 2026

Bile Duct Cancer Stages

The stage of bile duct cancer describes how far the cancer has grown and whether it has spread. Staging helps your doctors determine treatment options and estimate prognosis. One reason bile duct cancer staging can seem complicated is that intrahepatic, perihilar, and distal bile duct cancers each have their own staging criteria.

THE BASICS: Bile duct cancer is generally staged from stage 0 through stage IV using the TNM system. However, the exact criteria depend on whether the tumor is intrahepatic, perihilar, or distal. Doctors also consider whether the tumor is resectable, meaning it can be completely removed with surgery.

What does TNM mean?

T: Tumor

The T category describes the size of the tumor and how far it has grown into nearby tissue or structures.

N: Nodes

The N category describes whether cancer has spread to nearby lymph nodes.

M: Metastasis

The M category describes whether cancer has spread to distant organs.

Stage 0

Stage 0 is sometimes called carcinoma in situ or high-grade dysplasia. Abnormal cells are confined to the innermost lining of the bile duct and have not invaded deeper tissue.

Stage I

Stage I generally describes an early cancer that remains relatively limited to the bile duct or nearby tissue. The exact definition depends on tumor location. For example, intrahepatic stage I disease depends largely on tumor size, while distal bile duct staging considers how deeply the cancer has grown into the bile duct wall.

Stage II

Stage II generally means the cancer has grown farther into surrounding tissue, blood vessels, or nearby lymph nodes. Again, the criteria differ according to where the cancer began.

Stage III

Stage III bile duct cancer is generally more locally advanced. The cancer may involve:

  • Major blood vessels

  • Nearby organs

  • Liver tissue

  • Multiple nearby lymph nodes

Stage IV

Stage IV generally means the cancer has spread extensively to lymph nodes or distant parts of the body. Possible sites of metastasis include:

  • Lungs

  • Bones

  • Distant lymph nodes

  • Abdominal lining

  • Other organs

Resectable versus unresectable bile duct cancer

In addition to the stage number, doctors often describe bile duct cancer as resectable or unresectable.

Resectable

The tumor can potentially be completely removed with surgery.

Unresectable

The cancer cannot be completely removed with surgery. This may be because:

  • The tumor involves critical blood vessels

  • It has grown too extensively into nearby structures

  • It has spread to distant parts of the body

  • Surgery would not be safe because of other medical conditions

Whether bile duct cancer is resectable is one of the most important factors in determining treatment.

Recurrent bile duct cancer

Recurrent bile duct cancer means cancer has returned after treatment. It can recur:

  • Near the original tumor

  • In the liver

  • In nearby lymph nodes

  • In distant organs

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