Diagnosis & staging
Diagnosis
These are tests that may be used to diagnose this type of cancer.
- Most gallbladder cancers are found because of surgery to remove the gallbladder (cholecystectomy).
- Ultrasound
- Endoscopic ultrasound
- CT scan
- MRI
- Laparoscopy may be used for staging
- Biopsies are usually only done for gallbladder cancer if the tumour is inoperable.
For more information on tests used to diagnose cancer, see our
Recommended Websites, Diagnostic Tests section.
Types and Stages
- Adenocarcinomas
- About 95% of gallbladder cancers are adenocarcinomas.
- Adenocarcinomas begin in the cells that line the gallbladder. They invade the gallbladder wall as they grow. There are three types of adenocarcinomas:
- Non-papillary – more than 75% of adenocarcinomas are of the non-papillary type.
- Papillary adenocarcinomas – start in the connective tissues of the gallbladder and are less likely to spread than other types of adenocarcinomas. About 6% of gallbladder cancers are papillary adenocarcinomas.
- Mucinous – the least common type of adenocarcinoma.
- Rarer types of gallbladder cancer include:
- Sarcoma
- Squamous cell carcinoma
- Adenosquamous carcinoma
- Carcinosarcoma
- Signet ring carcinoma
- Small cell carcinoma
- Carcinoid
Staging describes the extent of a cancer. The TNM classification system is used as the standard around the world. In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.
T describes the site and size of the main tumour (primary)
N describes involvement of lymph nodes
M relates to whether the cancer has spread (presence or absence of distant metastases)
TX
Primary tumour cannot be assessed
T0
No evidence of primary tumour
Tis
Carcinoma in situ - cancer cells are only found in the inner (mucosal) layer of the gallbladder
T1
Tumour has grown into the lamina propria or the muscular layer of the gallbladder
T1a
Tumour has spread to the lamina propria
T1b
Tumour has spread to the muscular layer
T2
Tumour has grown into the perimuscular connective tissue. The cancer has not spread beyond the serosa or into the liver.
T3
Tumour has grown through the serosa of the gallbladder or the cancer has spread to the liver or one other nearby organ or structure. Nearby organs include the stomach, duodenum, colon, pancreas, omentum or extrahepatic bile ducts
T4
Tumour has grown into one of the main blood vessels leading into the liver (portal vein or hepatic artery) or has spread to two or more nearby organs other than the liver