{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:26:59Z","timestamp":1787837219135,"version":"build-2784847793"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T00:00:00Z","timestamp":1536710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T00:00:00Z","timestamp":1536710400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81672820"],"award-info":[{"award-number":["81672820"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81472677"],"award-info":[{"award-number":["81472677"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81672365"],"award-info":[{"award-number":["81672365"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Extrahepatic bile duct cancer (\n                    <jats:styled-content style=\"fixed-case\">EBDC<\/jats:styled-content>\n                    ) is a combined type of malignancy mainly consisting of extrahepatic cholangiocarcinoma and gallbladder cancer. Clinically, it is featured with latent symptoms and early metastasis, leading to a poor prognosis. Therefore, this cohort study aimed to depict the possible metastatic patterns of\n                    <jats:styled-content style=\"fixed-case\">EBDC<\/jats:styled-content>\n                    of diverse sub\u2010types and evaluate the prognostic significance of diverse metastatic destinations with data from the clinical database. Relevant data of total 4061 confirmed\n                    <jats:styled-content style=\"fixed-case\">EBDC<\/jats:styled-content>\n                    patients diagnosed between 2010 and 2013 from the Surveillance, Epidemiology and End Results (\n                    <jats:styled-content style=\"fixed-case\">SEER<\/jats:styled-content>\n                    ) database was obtained. We applied\n                    <jats:italic>t<\/jats:italic>\n                    test to describe the baseline data of patients included and used chi\u2010square test to compare the distribution of distant metastatic sites. We further adopted odds ratio assess the combined metastatic patterns and compared survival difference of patients with different distal metastasis organ by Kaplan\u2010Meier analysis\n                    <jats:bold>.<\/jats:bold>\n                    We identified totally 4061 patients over 18\u00a0years old diagnosed with extrahepatic bile tract malignancies between 2010 and 2013, with clear metastatic status and follow\u2010up data, without primary malignancies. Liver and distant lymph (\n                    <jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content>\n                    ) are the two most common sites as a single metastasis organ. In combined metastasis patterns, bi\u2010organ is more frequent than the other types. Lung is the organ preferentially for bi\u2010organ metastasis, while bone and distant lymph similarly intend to co\u2010metastasize with brain. Distal metastasis in\n                    <jats:styled-content style=\"fixed-case\">EBDC<\/jats:styled-content>\n                    patients indicates an extremely poor prognosis. According to the final analysis results, malignancies in extrahepatic bile duct exhibit similar metastatic patterns, suggesting that we can regard them as a unity to assess its development. Profound differences exist in distribution of distant extrahepatic metastatic sites and their combinations. Results from our studies would provide some information for follow\u2010up strategies and future studies.\n                  <\/jats:p>","DOI":"10.1002\/cam4.1772","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T22:30:00Z","timestamp":1536791400000},"page":"5006-5014","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Pattern of distant metastases in primary extrahepatic bile\u2010duct cancer: A\n                    <scp>SEER<\/scp>\n                    \u2010based study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3528-5785","authenticated-orcid":false,"given":"Xuan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of General Surgery Huashan Hospital Fudan University  Shanghai China"},{"name":"Cancer Metastasis Institute Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang\u2010Yang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of General Surgery Huashan Hospital Fudan University  Shanghai China"},{"name":"Cancer Metastasis Institute Fudan University  Shanghai China"},{"name":"Institutes of Biomedical Sciences Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery Huashan Hospital Fudan University  Shanghai China"},{"name":"Cancer Metastasis Institute Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of General Surgery Huashan Hospital Fudan University  Shanghai China"},{"name":"Cancer Metastasis Institute Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery Huashan Hospital Fudan University  Shanghai China"},{"name":"Cancer Metastasis Institute Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Surgery Huashan Hospital Fudan University  Shanghai China"},{"name":"Cancer Metastasis Institute Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,12]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ(R)): Health Professional Version 2002."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24227"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2018.04.010"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.15.S150"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2016.51"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo.2016.10.01"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21442"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.10.013"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-017-1620-7"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318216f5f3"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-006-9097-6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-016-1491-3"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.01.017"},{"issue":"118","key":"e_1_2_7_15_1","first-page":"1758","article-title":"Lymph nodes metastasis is a risk factor for bone metastasis from extrahepatic cholangiocarcinoma","volume":"59","author":"Katayose Y","year":"2012","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2015.05.013"},{"key":"e_1_2_7_17_1","unstructured":"Nagorney DM PTCY.AJCC cancer staging manual 8th Amin MB (Ed). Chicago;2017:217."},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5645-x"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcam4.1772","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.1772","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.1772","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.1772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T12:02:32Z","timestamp":1781092952000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.1772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,12]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1002\/cam4.1772"],"URL":"https:\/\/doi.org\/10.1002\/cam4.1772","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,12]]},"assertion":[{"value":"2018-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}