{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T17:44:41Z","timestamp":1790531081806,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The International Union Against Cancer (UICC) staging system for perihilar cholangiocarcinoma changed in 2009. The aim of this study was to validate and optimize the UICC system for these tumours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study was conducted in eight Japanese hospitals between 2001 and 2010. Perihilar cholangiocarcinoma was defined as a cholangiocarcinoma that involves the hilar bile duct, independent of the presence or absence of a liver mass component. The stratification ability of the UICC tumour node metastasis (TNM) system was compared with that of a modified system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1352 patients, 35\u00b79, 44\u00b78 and 12\u00b76 per cent had Bismuth type IV tumours, nodal metastasis (N1) and distant metastasis (M1) respectively. T4 tumours (43\u00b72 per cent) and stage IVA (T4 Nany M0; 36\u00b73 per cent) disease were most common. Survival was not significantly different between patients with T3versus T4 tumours (P = 0\u00b7284). Survival for patients with stage IVA disease was comparable to that for patients with stage IIIB tumours (T1\u20133 N1 M0) (P = 0\u00b7426). Vascular invasion, pancreatic invasion, positive margin, N1 and M1 status were identified as independent predictors of survival. When Bismuth type IV tumours were removed from the T4 determinants and N1 tumours grouped together, the modified grouping had a higher linear trend \u03c72 and likelihood ratio \u03c72 compared with the original system (245\u00b76 versus 170\u00b73 respectively and 255\u00b78 versus 209\u00b73 respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present data suggest that minimal modification with removal of Bismuth type IV tumours from the T4 determinants and bundling of N1 disease may enhance the prognostic ability of the UICC system. However, this requires validation on an independent data set.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.9379","type":"journal-article","created":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T09:45:34Z","timestamp":1387791934000},"page":"79-88","source":"Crossref","is-referenced-by-count":125,"title":["Proposal to modify the International Union Against Cancer staging system for perihilar cholangiocarcinomas"],"prefix":"10.1093","volume":"101","author":[{"given":"T","family":"Ebata","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine , Nagoya,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Kosuge","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine , Sapporo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Unno","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological Surgery, Department of Surgery, Tohoku University Graduate School of Medicine , Sendai,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Chiba University Graduate School of Medicine , Chiba,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Kokudo","sequence":"additional","affiliation":[{"name":"Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tokyo University Graduate School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Miyagawa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological Surgery, Shinshu University School of Medicine , Matsumoto,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Surgery, Teikyo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Nagino","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine , Nagoya,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,1,1]]},"reference":[{"key":"2024092904521794500_bjs9379-bib-0001","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/00000658-199610000-00005","article-title":"Cholangiocarcinoma. 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