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As tumor histomorphological features are significantly altered after neoadjuvant therapy (NAT), our study aims to assess the prognostic significance of TB in iCCA patients before and after NAT, by the modified International Tumor Budding Consensus Conference (ITBCC) criteria. 147 NAT-treated iCCA cases were included in this study. In biopsy specimens obtained before NAT, the TB-positive subgroup had lower overall survival (OS) in univariate analysis (<jats:italic>P<\/jats:italic>\u2009=\u20090.010). In resection specimens obtained after NAT, the TB-positive subgroup had reduced OS (<jats:italic>P<\/jats:italic>\u2009=\u20090.002) and recurrence-free survival (RFS) (<jats:italic>P<\/jats:italic>\u2009=\u20090.013) in univariate analysis. In multivariate analysis including TNM stage, lymphovascular invasion and perineural invasion, TB-positive in post-NAT resection was also found as an independent prognostic factor for both OS and RFS (OS, HR, 3.005; 95% CI, 1.333\u20136.775, <jats:italic>P<\/jats:italic>\u2009=\u20090.008; RFS, HR, 1.748; 95% CI, 1.085\u20132.816, <jats:italic>P<\/jats:italic>\u2009=\u20090.022). In conclusion, assessing the presence of TB by modified ITBCC criteria provides robust prognostic information in the NAT setting of iCCA patients and can be considered to be included in routine pathological reporting.<\/jats:p>","DOI":"10.1007\/s00428-024-03937-y","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T01:01:44Z","timestamp":1728522104000},"page":"913-923","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Tumor budding in pre-neoadjuvant biopsy and post-neoadjuvant resection specimens is associated with poor prognosis in intrahepatic cholangiocarcinoma\u2014a cohort study of 147 cases by modified ITBCC criteria"],"prefix":"10.1007","volume":"485","author":[{"given":"Gaohua","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongkui","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianhui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuxiao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongping","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Chew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye Xin","family":"Koh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth Tou En","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoyu","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8401-7124","authenticated-orcid":false,"given":"Kai","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"issue":"2","key":"3937_CR1","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1038\/nrclinonc.2017.157","volume":"15","author":"SI Ilyas","year":"2018","unstructured":"Ilyas SI, Khan SA, Hallemeier CL, Kelley RK, Gores GJ (2018) Cholangiocarcinoma-evolving concepts and therapeutic strategies. 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