{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:31:04Z","timestamp":1790771464559,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Purpose<\/jats:title><jats:p>The eighth edition of the AJCC staging system introduced a shift in the staging of distal bile duct cancer (DBC), emphasizing the depth of invasion over adjacent organ invasion. This study aimed to evaluate the clinical impact of pancreatic invasion in pT1\u2010stage DBC and identify prognostic factors for long\u2010term survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter retrospective analysis encompassed DBC patients who underwent pancreaticoduodenectomy between 2009 and 2019 in six Korean tertiary centers, specifically those with final pathology confirming AJCC eighth edition T1 stage and intrapancreatic bile duct tumor origin. Primary endpoints were five\u2010year recurrence\u2010free survival (RFS) and overall survival (OS). Secondary objectives included the identification of prognostic determinants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study involved 287 patients, comprising 190 without and 97 with pancreatic invasion. Pancreatic invasion did not significantly influence five\u2010year OS and RFS rates (OS: without pancreatic invasion 69.9% vs. with pancreatic invasion 54.1%, <jats:italic>p<\/jats:italic>\u2009=\u2009.25; RFS: 56.3% vs. 55.4%, <jats:italic>p<\/jats:italic>\u2009=\u2009.97). Multivariate analysis highlighted male gender, age, lymphovascular invasion, and N stage as significant OS determinants. Notably, male gender, ampulla of Vater invasion, lymphovascular invasion, and N1 stage were also associated with RFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In pT1 DBC, pancreatic invasion demonstrates no substantial impact on long\u2010term prognosis, in accordance with the depth\u2010based paradigm of the eighth edition AJCC staging system. The prognostic factors influencing OS were identified as male gender, age, lymphovascular invasion, and nodal metastasis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.12042","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T05:15:03Z","timestamp":1721970903000},"page":"658-670","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical impact of pancreatic invasion in T1\u2010stage distal bile duct cancer and prognostic factors associated with long\u2010term survival: A multicenter study"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4434-4855","authenticated-orcid":false,"given":"Ye Won","family":"Jeon","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery University of Ulsan College of Medicine, Asan Medical Center  Seoul 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Center  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song Cheol","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery University of Ulsan College of Medicine, Asan Medical Center  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-4491","authenticated-orcid":false,"given":"Sang Hyun","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary Pancreatic Surgery, Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1749-038X","authenticated-orcid":false,"given":"Dae Wook","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery University of Ulsan College of 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