Stages of Gall Bladder Cancer Explained: From Diagnosis to Treatment
                     Stages of Gall Bladder 
Cancer Explained: From 
Diagnosis to Treatment
What Is Gallbladder Cancer?
• A malignant tumor arising from the 
gallbladder, most commonly 
adenocarcinoma
• Risk factors: gallstones, chronic 
inflammation, porcelain gallbladder, older 
age, female sex
• Often asymptomatic early; can present 
with pain, jaundice, weight loss
• Early detection improves outcomes—hence 
the importance of staging
Diagnosis: From Symptoms to Confirmation
• History and exam: right upper quadrant 
pain, jaundice, fever, cachexia
• Labs: liver function tests, bilirubin, CA 19-
9/CEA (non-specific adjuncts)
• Imaging: ultrasound first-line; contrast 
CT/MRI for staging detail
• MRCP/EUS ± FNA for biliary/lymph node 
assessment when needed
Staging Basics (AJCC TNM)
• T: depth of invasion through gallbladder 
wall and adjacent organ involvement
• N: spread to regional lymph nodes (number 
and location)
• M: distant metastasis (liver beyond direct 
invasion, peritoneum, lung, etc.)
• Stages group from I (localized) to IV 
(metastatic), guiding treatment choices
Stage I–II: Localized Disease
• T1a incidentally found: simple 
cholecystectomy may be adequate
• T1b–T2: extended cholecystectomy 
(segments IVb/V) with regional 
lymphadenectomy
• Aim for R0 resection; evaluate cystic duct 
margins and liver bed
• Adjuvant therapy (e.g., capecitabine) 
considered to reduce recurrence risk
Stage III: Locally Advanced
• Invasion into liver or adjacent organs, or 
multiple regional lymph nodes
• Multidisciplinary evaluation in GI Oncology 
tumor board is essential
• Options: extended hepatic resection, bile 
duct resection if indicated
• Neoadjuvant or adjuvant systemic 
therapy/radiation considered case-by-case
Stage IV: Metastatic Disease
• First-line: gemcitabine + cisplatin + 
immunotherapy (e.g., durvalumab) when 
eligible
• Second-line: FOLFOX or other regimens 
based on fitness and prior therapy
• Molecular testing: MSI-H/TMB-high for 
immunotherapy; HER2 alterations may 
guide targeted therapy
• Clinical trials strongly encouraged at 
Action Cancer Hospital
Supportive Care and Biliary Drainage
• Relieve obstruction: ERCP stent or 
percutaneous drainage to reduce bilirubin
• Optimize symptom control: pain, pruritus, 
nausea, nutrition and infection prevention
• Early palliative care integration improves 
quality of life and outcomes
• Physical therapy and dietician support are 
part of multidisciplinary care
Follow-Up, Prognosis, and Next Steps
• Surveillance: exam, labs, and imaging 
every 3–6 months initially after curative 
therapy
• Prognosis depends on stage, margins, 
nodal status, and response to therapy
• Personalized care plans and trial options 
available through our GI Oncology 
program
• Contact Action Cancer Hospital to discuss 
individualized treatment pathways
CONTACT US
• 011-49-222-222 
•[email protected] 
•www.actioncancerhospital.com 
• A - 4, Paschim Vihar, Near 
Paschim Vihar East Metro Station 
New Delhi 110063