Staging of gallbladder cancer

The stage of a cancer describes its size and whether it has spread from where it started. Knowing the stage of the cancer helps doctors decide on the best treatment for you.

Cancer can spread through the bloodstream or the lymphatic system. Doctors usually look at lymph nodes close to the gallbladder to find out the stage of the cancer.

There are different ways of staging cancers. The number staging system and the TMN staging system are usually used for gallbladder cancer.

Number staging system

This staging system uses numbers to describe the stage of the cancer. There are four stages of gallbladder cancer:

  • Stage 1
    The cancer affects only the wall of the gallbladder.
  • Stage 2
    The cancer has spread through the wall of the gallbladder, but not to nearby lymph nodes or surrounding organs.
  • Stage 3
    The cancer has spread to lymph nodes close to the gallbladder or has spread to the liver, stomach, colon or small bowel.
  • Stage 4
    The cancer has spread very deeply into two or more organs close to the gallbladder, or it has spread to distant lymph nodes or organs, such as the lungs. This is known as metastatic or secondary cancer.

TNM staging system

A different system called the TNM staging system is sometimes used. TNM stands for tumour, node and metastases.

  • T describes the size of the tumour
  • N describes whether the cancer has spread to the lymph nodes and which nodes are involved. For example, N0 means no lymph nodes affected, while N1 means there are cancer cells in the lymph nodes.
  • M describes whether the cancer has spread to another part of the body (this is called (secondary or metastatic cancer). For example, M0 means the cancer has not spread (metastasised) to other parts of the body.

Grading of gallbladder cancer

Grading is about how the cancer cells look under a microscope compared with normal cells. The grade helps your doctor decide if you need further treatment after surgery.

  1. Grade 1, low-grade or well differentiated – the cancer cells look similar to normal cells and usually grow slowly and are less likely to spread.
  2. Grade 2, moderate or intermediate-grade – the cancer cells look more abnormal and are slightly faster growing
  3. Grade 3, high-grade or poorly differentiated – the cancer cells look very different from normal cells and may grow more quickly.

About our information


  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Paul Ross, Consultant Medical Oncologist.

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