{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:22:42Z","timestamp":1787498562403,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Primary liver malignancies, such as hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined hepatocellular\u2010cholangiocarcinoma (cHCC\u2010CCA), represent significant contributors to global cancer\u2010related mortality. The diagnostic challenges associated with distinguishing cHCC\u2010CCA from HCC and ICC stem from their rarity and overlapping histological features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to reclassify primary liver tumors resected at a Western center and to compare clinicopathological features and prognosis among patients with HCC, ICC, and cHCC\u2010CCA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on patients undergoing resection for HCC, ICC, or cHCC\u2010CCA between 2007 and 2017. Clinical and perioperative data were collected, and pathological specimens were reclassified by a specialized pathologist. Statistical analysis was employed to compare clinical features and survival outcomes among the different tumor types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of the initially identified 192 patients, 140 were included in the analysis. Following reclassification, 71.42% were diagnosed with HCC, 12.14% with ICC, and 16.42% with cHCC\u2010CCA. Patients with HCC were predominantly male and exhibited a higher incidence of isolated liver recurrence. ICC patients more frequently underwent open procedures. Additionally, patients with HCC and cHCC\u2010CCA showed higher rates of cirrhosis, elevated alpha\u2010fetoprotein levels, and extrahepatic recurrence, while those with ICC and cHCC\u2010CCA demonstrated elevated CA 19\u20109 levels. Overall survival and disease\u2010free survival were longer for HCC compared to cases with a cholangiolar component (ICC and cHCC\u2010CCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Histological evaluation should actively incorporate the search for a cholangiolar component in primary liver tumors to prevent misdiagnosis, as its presence indicates a poorer prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.27955","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T01:56:01Z","timestamp":1729043761000},"page":"427-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prognostic Impact of the Cholangiolar Component in Combined Hepatocellular\u2010Cholangiocarcinoma: Insights From a Western Single\u2010Center Study"],"prefix":"10.1002","volume":"131","author":[{"given":"Francisco","family":"Nolasco","sequence":"first","affiliation":[{"name":"Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division University of Sa\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7260-0799","authenticated-orcid":false,"given":"Gilton Marques","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division University of Sa\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4383-2910","authenticated-orcid":false,"given":"Evandro S.","family":"de Mello","sequence":"additional","affiliation":[{"name":"Departament of Pathology University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-4927","authenticated-orcid":false,"given":"Jaime Arthur Pirolla","family":"Kruger","sequence":"additional","affiliation":[{"name":"Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division University of Sa\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-1960","authenticated-orcid":false,"given":"Vagner Birk","family":"Jeismann","sequence":"additional","affiliation":[{"name":"Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division University of Sa\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8202-5890","authenticated-orcid":false,"given":"Fabio Ferrari","family":"Makdissi","sequence":"additional","affiliation":[{"name":"Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division University of Sa\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5290-8286","authenticated-orcid":false,"given":"Fabricio Ferreira","family":"Coelho","sequence":"additional","affiliation":[{"name":"Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division University of Sa\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venancio A. 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