Synonyms in the broadest sense
Therapy of bile duct carcinoma, bile duct tumor, treatment of bile duct carcinoma, cholangiocarcinoma (CCC), cholangiocarcinoma, bile system cancer, klatskin tumor, hilary cholangiocarcinoma
Staging
An exact assessment of the tumor stage is often only possible after the operation, when the tumor has been removed (resected) and the surgical preparation (resected tissue) and the lymph nodes have been histologically examined. 1. T-stages:
- T0: No reference to the primary tumor
- Tis: Carcinoma in situ.
This is an incipient tumor that has not ruptured the basement membrane and therefore cannot metastasize because it has no connection to blood vessels.
- T1: Tumor is restricted to one bile duct
- T2: Infiltration also outside the bile duct
- T3: Infiltration into the liver, gallbladder, pancreas and/or branches of the portal vein and branches of the hepatic artery from the left or right.
- T4: Tumor grows into one or more adjacent structures: Main stem of the vena portae or its branches from the right and left lobe of the liver, the hepatic artery (A. hepatica communis) or neighbouring organs such as the colon, stomach, duodenum and abdominal wall.
2. n-stages: 3. m-stages: The Klatskin tumor, which develops at the junction of the bile ducts of the right and left lobe of the liver, has a special classification. This is also called the bismuth corlette classification: Type I: The tumor infiltrates only the common hepatic duct. Type II:The tumor reaches the bifurcation of the common hepatic duct Type IIIa: The tumor infiltrates the bile duct for the right lobe of the liver (Ductus hepaticus dexter) and also reaches the associated hepatic segment inflows Type IIIb:The tumor infiltrates the bile duct for the left lobe of the liver (Ductus hepaticus sinister) and also reaches the associated hepatic segment inflows Type IV:The tumor infiltration reaches the hepatic segment bile ducts on the right and left side.
- N0: No lymph node metastases detectable
- N1: Surrounding (regional) lymph node metastases between the liver and duodenum (hepatoduodenal ligament) are affected.
- M0: no distant metastases detectable
- M1: distant metastases (especially liver, later also lung)
