Summary of Changes
The T and N classifications have been redefined and simplified.
Invasion of the subepithelial fibro (muscular) connective tissue is classified as T1 irrespective of muscular invasion, which cannot always be noted because of the scarcity of muscle fibers in some bile duct segments.
T2 is defined as invasion beyond the wall of the bile duct.
The T classification allows one to separate locally invasive tumors into resectable (T3) and unresectable (T4).
Invasion of branches of the portal vein (right or left), hepatic artery, or liver is classified as T3.
Invasion of the main portal vein, common hepatic artery, and/or regional organs is classified as T4.
The stage grouping has been changed to allow Stage III to signify locally unresectable disease and Stage IV to indicate metastatic disease.
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© 2002 Springer Science+Business Media New York
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American Joint Committee on Cancer. (2002). Extrahepatic Bile Ducts. In: Greene, F.L., et al. AJCC Cancer Staging Manual. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3656-4_16
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