Japanese Society of Biliary Surgery (JSBS) Staging Classification for Gallbladder Cancer

Tumor

T Status

tumor invades the submucosa or muscle layer

T1

tumor invades the perimuscular connective tissue

T2

perforates the serosa or invades <= 2 cm into the liver

T3

invades > 2 cm into the liver or invades >= 2 adjacent organs

T4

Lymph Nodes and Other Structures

n Status

negative

n0

metastasis to cystic duct and/or pericholedochal lymph nodes

n1

metastasis in hepatoduodenal ligament, lymph nodes at postero-superior pancreas head or along the common hepatic artery

n2

metastasis into peripancreatic (except postero-superior), celiac, superior mesenteric or para-aortic lymph nodes

n3

metastases to lymph nodes beyond n3

n4

Distant Metastasis

M Status

none

M0

any

M1

TnM

Stage

T1 n0 M0

I

T1 n1 M0; T2 n0 M0; T2 n1 M0

II

T1 n2 M0; T2 n2 M0; T3 n0 M0; T3 n1 M0; T2 n2 M0

III

T4 n0 M0; T4 n1 M0; T4 n2 M0; anyT n3 M0

IVa

anyT n4 M0; anyT any-n M1

IVb

Tumor

T Status

tumor invades the submucosa or muscle layer

T1

tumor invades the perimuscular connective tissue

T2

perforates the serosa or invades <= 2 cm into the liver

T3

invades > 2 cm into the liver or invades >= 2 adjacent organs

T4

Lymph Nodes and Other Structures

n Status

negative

n0

metastasis to cystic duct and/or pericholedochal lymph nodes

n1

metastasis in hepatoduodenal ligament, lymph nodes at postero-superior pancreas head or along the common hepatic artery

n2

metastasis into peripancreatic (except postero-superior), celiac, superior mesenteric or para-aortic lymph nodes

n3

metastases to lymph nodes beyond n3

n4

Distant Metastasis

M Status

none

M0

any

M1

TnM

Stage

T1 n0 M0

I

T1 n1 M0; T2 n0 M0; T2 n1 M0

II

T1 n2 M0; T2 n2 M0; T3 n0 M0; T3 n1 M0; T2 n2 M0

III

T4 n0 M0; T4 n1 M0; T4 n2 M0; anyT n3 M0

IVa

anyT n4 M0; anyT any-n M1

IVb