{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T21:35:09Z","timestamp":1788298509253,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T00:00:00Z","timestamp":1521849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Grants-in-aid for Cancer Research and for the Third-term Comprehensive 10-year Strategy for Cancer Control from the Ministry of Health, Labour and Welfare of Japan","award":["JSPS KAKENHI Grant Number 22790624"],"award-info":[{"award-number":["JSPS KAKENHI Grant Number 22790624"]}]},{"name":"The National Cancer Research and Develop Fund","award":["235A52b"],"award-info":[{"award-number":["235A52b"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The invasive front of tumor can provide prognostic information in many cancers. We investigated the prognostic morphological factors at the invasive front including tumor differentiation (Dif<jats:sup>inv<\/jats:sup>) and tumor budding (Bud) in biliary tract cancer (BTC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The resected specimen from the 299 BTC patients were examined. Intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder cancer, and ampulla of Vater cancer were found in 16%, 48%, 17%, and 19%, respectively. Dif<jats:sup>inv<\/jats:sup>grade (G) 3 and Bud foci \u22655 were found in 47% and 10%. Tumor with Dif<jats:sup>inv<\/jats:sup>G3 showed the high frequencies of Bud, vascular invasion (Ve) and nodal metastasis (LN) compared to tumor with Dif<jats:sup>inv<\/jats:sup>G1\/2 (Bud: 21% vs 0%, Ve: 71% vs 50%, LN: 52% vs 36%). Multivariate analysis revealed that the independent predictors were Dif<jats:sup>inv<\/jats:sup>G3 (HR: 1.71), Bud foci \u22655 (HR: 2.14), Ve (HR: 1.56) and LN (HR: 2.59) in overall survival and were positive resection margin (HR: 1.71), Dif<jats:sup>inv<\/jats:sup>G3 (HR: 1.75), Ve (HR: 1.50), and LN (HR: 2.19) in relapse free survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Poor differentiation at the invasive front of tumor was associated with poor prognosis and early relapse in BTC patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.24946","type":"journal-article","created":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T08:55:38Z","timestamp":1521881738000},"page":"1278-1287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["The prognostic impact of differentiation at the invasive front of biliary tract 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