Skip to main content

ACS & ASCO are Stronger Together: Cancer.Net content is now available on


Bile Duct Cancer Stages

The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer's stage when talking about survival statistics.

The stage of a bile duct cancer is determined by the results of the physical exam, imaging and other tests, and by the results of surgery if it has been done.

The American Joint Committee on Cancer (AJCC) TNM system

A staging system is a standard way for the cancer care team to sum up the extent of a cancer. The main system used to describe the stages of bile duct cancer is the American Joint Committee on Cancer (AJCC) TNM system. There are actually 3 different staging systems for bile duct cancers, depending on where they start:

illustration showing the location of the common bile duct, intrahepatic bile ducts, perihilar bile ducts and distal bile ducts in relation to the liver, pancreas, gallbladder and duodenum (intestine)

Nearly all bile duct cancers start in the innermost layer of the wall of the bile duct, called the mucosa. Over time they can grow through the wall toward the outside of the bile duct. If a tumor grows through the bile duct wall, it can invade (grow into) nearby blood vessels, organs, and other structures. It might also grow into nearby lymphatic or blood vessels, and from there spread to nearby lymph nodes or to other parts of the body.

Resectable versus unresectable

The TNM staging system provides a detailed summary of how far the bile duct cancer has spread and gives doctors an idea about a person’s prognosis (outlook). But for treatment purposes, doctors often use a simpler system based on whether or not the cancer can probably be removed (resected) with surgery:

  • Resectable cancers are those that doctors believe can be removed completely by surgery.
  • Unresectable cancers have spread too far or are in too difficult a place to be removed entirely by surgery.

In general terms, most stage 0, I, and II cancers and possibly some stage III cancers are resectable, while most stage III and IV tumors are unresectable. But this depends on other factors, too, such as the size and location of the cancer and whether a person is healthy enough for surgery.

More information

For more detailed staging information based on the type of bile duct cancer, choose an option below.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.

American Joint Committee on Cancer.  AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer; 2010: 201-205; 295-325.

Last Revised: July 3, 2018

American Cancer Society Emails

Sign up to stay up-to-date with news, valuable information, and ways to get involved with the American Cancer Society.