Table 1. Comparison of the main used classification of phCCA.
| Classification | Bismuth-Corlette | AJCC/UICC (TNM) | Blumberg-Jarnagin (MSKCC) (13) |
|---|---|---|---|
| X and 0 | – | TX: primary tumor cannot be assessed | – |
| T0: no evidence of tumor | |||
| Tis: tumor in situ | |||
| Type 1 | CHD below the confluence | T1: confined to the bile duct, with extension up to the muscle layer of fibrous tissue | The tumor involves the biliary confluence with unilateral involvement up to secondary biliary radicles. There is no portal vein involvement or liver atrophy |
| Type 2 | Type I to the confluence | T2a: tumor invades beyond the wall of the bile duct to surrounding adipose tissue | The tumor involves the biliary confluence with unilateral involvement up to secondary biliary radicles. There is ipsilateral portal vein involvement or ipsilateral hepatic lobar atrophy |
| T2b: invades adjacent hepatic parenchyma | |||
| Type 3 | IIIa: type 2 + RHD; IIIb: type 2 + LHD | T3: tumor invades unilateral branches of the portal vein or hepatic artery | The tumor involves the biliary confluence with bilateral involvement up to secondary biliary radicles, unilateral extension to secondary biliary radicles with contralateral portal vein involvement, unilateral involvement up to secondary biliary radicles with contralateral hepatic lobar atrophy, or main/bilateral portal vein involvement. |
| Type 4 | Type IIIa + IIIb or more | T4: tumor invades main portal vein or its branches bilaterally, or the common hepatic artery or the second-order biliary radicals bilaterally, or unilateral second order biliary radicles with contralateral portal vein or hepatic artery involvement | – |
| Nx: Cannot be assessed; N0: no regional lymph node metastases; N1: regional lymph node metastases to nodes along the cystic duct, common bile duct, hepatic artery, and portal vein; N2: metastases to periaortic, pericaval, superior mesenteric artery, and/or celiac artery nodes | |||
| Mx: cannot be assessed; M0: no metastases; M1: distant metastases present |
phCCA, perihilar cholangiocarcinoma; CHD, common hepatic duct; RHD, main right hepatic duct; LHD, main left hepatic duct.