End stage gallbladder cancer is also called stage 4 gallbladder cancer. It’s harder to treat than cancer caught in earlier stages. Symptoms include jaundice, abdominal pain, nausea, and fever.

The American Cancer Society (ACS) estimates that about 12,220 people in the United States will receive diagnoses of gallbladder cancer or nearby large bile duct cancer in 2023. Gallbladder cancer is the 22nd most common and 17th most fatal cancer worldwide.

End stage gallbladder cancer, also called stage 4 gallbladder cancer, refers to gallbladder cancer that’s spread to at least one of the following:

  • the major blood vessels leading to your liver
  • multiple structures outside the liver
  • four or more nearby lymph nodes
  • distant organs

Once gallbladder cancer spreads to distant organs, the outlook is usually poor. According to the ACS, the 5-year relative survival rate remains about 3%.

Gallbladder cancer often doesn’t cause symptoms in the early stages, which often delays its diagnosis. Only 1 out of 5 gallbladder cancers are discovered in an early stage. Most aren’t found until they’re in an advanced stage.

In this article, we take a deeper look at end stage gallbladder cancer, including its definition, symptoms, and treatment options.

End stage gallbladder cancer refers to cancer that’s reached stage 4 in the American Joint Committee on Cancer (AJCC)’s TNM staging system. THE AJCC’s staging system is the most common way doctors stage gallbladder cancer. It stages gallbladder cancer from stage 0 to stage 4 depending on:

  • T: the size of the tumor
  • N: how many nearby lymph nodes the cancer has spread to
  • M: whether the cancer has spread to distant organs

Stage 4 cancer can be divided into two subcategories:

Stage 4AStage 4B
T: The tumor has grown into one of the main blood vessels leading to the liver or two or more structures outside your liver.

N: The cancer may or may not have spread to up to three nearby lymph nodes.

M: The cancer has not spread to distant sites.
T: The cancer may or may not have grown outside the gallbladder.

N: The cancer has spread to four or more nearby lymph nodes.

M: It has not spread to distant sites.


T: The cancer may or may not have grown outside the gallbladder.

N: The cancer may or may not have spread to nearby lymph nodes.

M: The cancer has spread to distant organs such as the liver, lungs, or lining of your abdomen.

Some doctors use other staging systems. The ACS and National Cancer Institute (NCI) use a 3-stage system when reporting gallbladder survival statistics. They divide gallbladder cancer into:

  • local
  • regional
  • distant

Gallbladder cancer can be difficult to diagnose in the early stages. This is because it often doesn’t cause any symptoms until the cancer grows large or spreads. When symptoms do appear, they’re often general and similar to symptoms of many other conditions.

Signs and symptoms of gallbladder cancer can include:

Gallbladder cancer that’s spread too far to be removed surgically is usually not considered curable. Treatment often revolves around prolonging your life and lowering your symptoms.

Treatment for advanced gallbladder cancer usually includes:

  • chemotherapy
  • stents or surgical bypass to allow bile to flow from the liver into the small intestines

The NCI recommends enrolling in clinical trials for end stage gallbladder cancer whenever possible. Clinical trials may give you access to state-of-the-art treatment.

Your doctor may recommend clinical trials that you may be eligible for. Or you may find them on the NCI and National Library of Medicine websites.

End stage gallbladder cancer tends to have a poor outlook, especially if it’s spread to other organs at the time it was diagnosed.

People with advanced gallbladder cancer have a 5-year relative survival rate of about 3%, according to the ACS. This means they live at least 5 years of about 3% as often as someone without gallbladder cancer.

Here’s a look at gallbladder survival by stage, as per the NCI’s SEER data for 2012–2018:

Stage5-year relative survival rate
all stages20%

The survival rate for advanced gallbladder cancer will likely continue to rise in the future as doctors learn how to best treat it.

Factors affecting outlook

Some factors may give you a better or worse outlook than most people with your stage of cancer.

Factors linked to a worse outlook include:

  • higher grade cancer, meaning the cancer is more aggressive
  • some rare cancer subtypes, such as squamous and adenosquamous carcinoma
  • cancer that’s spread to your blood vessels or lymph system
  • cancer that can’t be removed surgically

End stage gallbladder cancer is also called stage 4 cancer. Your doctor may tell you that you have stage 4 gallbladder cancer if it’s spread to major blood vessels, nearby lymph nodes, or other structures outside your gallbladder.

Stage 4 gallbladder cancer usually isn’t considered curable. Treatment may focus on prolonging your life and reducing your symptoms.

Enrolling in a clinical trial may give you access to newer treatments that might be more effective than current treatment options.