{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T06:31:56Z","timestamp":1786689116947,"version":"build-2736575974"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastroenterol"],"DOI":"10.1007\/s00535-026-02498-y","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T06:12:31Z","timestamp":1786687951000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of subcutaneous adiposity with survival outcomes in advanced biliary tract cancer treated with gemcitabine, cisplatin, and immune checkpoint inhibitor"],"prefix":"10.1007","author":[{"given":"Tsuyoshi","family":"Takeda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7109-9835","authenticated-orcid":false,"given":"Takashi","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuki","family":"Hirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichiro","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Hamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Maegawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Mie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaaki","family":"Furukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukari","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Ozaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Sasahira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2498_CR1","doi-asserted-by":"publisher","DOI":"10.1056\/evidoa2200015","author":"D-Y Oh","year":"2022","unstructured":"Oh D-Y, Ruth He A, Qin S, Chen L-T, Okusaka T, Vogel A, et al. Durvalumab plus gemcitabine and cisplatin in advanced biliary tract cancer. NEJM Evidence. 2022. https:\/\/doi.org\/10.1056\/evidoa2200015.","journal-title":"NEJM Evidence"},{"issue":"10391","key":"2498_CR2","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.1016\/S0140-6736(23)00727-4","volume":"401","author":"RK Kelley","year":"2023","unstructured":"Kelley RK, Ueno M, Yoo C, Finn RS, Furuse J, Ren Z, et al. Pembrolizumab in combination with gemcitabine and cisplatin compared with gemcitabine and cisplatin alone for patients with advanced biliary tract cancer (KEYNOTE-966): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2023;401(10391):1853\u201365.","journal-title":"Lancet"},{"key":"2498_CR3","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13030558","author":"A Rizzo","year":"2021","unstructured":"Rizzo A, Ricci AD, Brandi G. PD-L1, TMB, MSI, and other predictors of response to immune checkpoint inhibitors in biliary tract cancer. Cancers (Basel). 2021. https:\/\/doi.org\/10.3390\/cancers13030558.","journal-title":"Cancers (Basel)"},{"key":"2498_CR4","doi-asserted-by":"publisher","DOI":"10.3390\/cells12162098","author":"G Frega","year":"2023","unstructured":"Frega G, Cossio FP, Banales JM, Cardinale V, Macias RIR, Braconi C, et al. Lacking immunotherapy biomarkers for biliary tract cancer: a comprehensive systematic literature review and meta-analysis. Cells. 2023. https:\/\/doi.org\/10.3390\/cells12162098.","journal-title":"Cells"},{"issue":"1","key":"2498_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-019-0738-1","volume":"12","author":"P Zhao","year":"2019","unstructured":"Zhao P, Li L, Jiang X, Li Q. Mismatch repair deficiency\/microsatellite instability-high as a predictor for anti-PD-1\/PD-L1 immunotherapy efficacy. J Hematol Oncol. 2019;12(1):54.","journal-title":"J Hematol Oncol"},{"issue":"10","key":"2498_CR6","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1093\/annonc\/mdu042","volume":"25","author":"DSM Chan","year":"2014","unstructured":"Chan DSM, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25(10):1901\u201314.","journal-title":"Ann Oncol"},{"issue":"3","key":"2498_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2024.102241","volume":"9","author":"H Wen","year":"2024","unstructured":"Wen H, Deng G, Shi X, Liu Z, Lin A, Cheng Q, et al. Body mass index, weight change, and cancer prognosis: a meta-analysis and systematic review of 73 cohort studies. ESMO Open. 2024;9(3):102241.","journal-title":"ESMO Open"},{"issue":"7","key":"2498_CR8","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S1470-2045(08)70153-0","volume":"9","author":"CM Prado","year":"2008","unstructured":"Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9(7):629\u201335.","journal-title":"Lancet Oncol"},{"issue":"3","key":"2498_CR9","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.3520","volume":"4","author":"F Petrelli","year":"2021","unstructured":"Petrelli F, Cortellini A, Indini A, Tomasello G, Ghidini M, Nigro O, et al. Association of obesity with survival outcomes in patients with cancer: a systematic review and meta-analysis. JAMA Netw Open. 2021;4(3):e213520.","journal-title":"JAMA Netw Open"},{"issue":"6","key":"2498_CR10","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35799","volume":"131","author":"EV Mastrolonardo","year":"2025","unstructured":"Mastrolonardo EV, Llerena P, De Ravin E, Nunes K, Kaki PC, Bridgham KM, et al. Improved survival with elevated BMI following immune checkpoint inhibition across various solid tumor cancer types. Cancer. 2025;131(6):e35799.","journal-title":"Cancer"},{"key":"2498_CR11","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1557726","volume":"16","author":"Y Li","year":"2025","unstructured":"Li Y, Yu Y, Lv K, Ge R, Xie X. Prognostic value of body adipose tissue parameters in cancer patients treated with immune checkpoint inhibitors. Front Immunol. 2025;16:1557726.","journal-title":"Front Immunol"},{"issue":"1","key":"2498_CR12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/s44324-024-00007-4","volume":"2","author":"LV Vick","year":"2024","unstructured":"Vick LV, Rosario S, Riess JW, Canter RJ, Mukherjee S, Monjazeb AM, et al. Potential roles of sex-linked differences in obesity and cancer immunotherapy: revisiting the obesity paradox. NPJ Metab Health Dis. 2024;2(1):5.","journal-title":"NPJ Metab Health Dis"},{"key":"2498_CR13","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1198723","volume":"13","author":"X Pei","year":"2023","unstructured":"Pei X, Xie Y, Liu Y, Cai X, Hong L, Yang X, et al. Imaging-based adipose biomarkers for predicting clinical outcomes of cancer patients treated with immune checkpoint inhibitors: a systematic review. Front Oncol. 2023;13:1198723.","journal-title":"Front Oncol"},{"issue":"12","key":"2498_CR14","doi-asserted-by":"publisher","DOI":"10.1002\/mco2.70494","volume":"6","author":"T Chen","year":"2020","unstructured":"Chen T, Zhai W, Song J, Liu W, Wu Z, Yang F, et al. Obesity paradox in cancer: a complex interplay between risk and therapeutic outcomes. MedComm. 2020;6(12):e70494.","journal-title":"MedComm"},{"issue":"8018","key":"2498_CR15","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1038\/s41586-024-07529-3","volume":"630","author":"JE Bader","year":"2024","unstructured":"Bader JE, Wolf MM, Lupica-Tondo GL, Madden MZ, Reinfeld BI, Arner EN, et al. Obesity induces PD-1 on macrophages to suppress anti-tumour immunity. Nature. 2024;630(8018):968\u201375.","journal-title":"Nature"},{"issue":"1","key":"2498_CR16","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1038\/s41591-018-0221-5","volume":"25","author":"Z Wang","year":"2019","unstructured":"Wang Z, Aguilar EG, Luna JI, Dunai C, Khuat LT, Le CT, et al. Paradoxical effects of obesity on T cell function during tumor progression and PD-1 checkpoint blockade. Nat Med. 2019;25(1):141\u201351.","journal-title":"Nat Med"},{"issue":"3","key":"2498_CR17","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1507\/endocrj.EJ23-0593","volume":"71","author":"W Ogawa","year":"2024","unstructured":"Ogawa W, Hirota Y, Miyazaki S, Nakamura T, Ogawa Y, Shimomura I, et al. Definition, criteria, and core concepts of guidelines for the management of obesity disease in Japan. Endocr J. 2024;71(3):223\u201331.","journal-title":"Endocr J"},{"issue":"2","key":"2498_CR18","doi-asserted-by":"publisher","first-page":"121","DOI":"10.7570\/jomes23031","volume":"32","author":"JH Haam","year":"2023","unstructured":"Haam JH, Kim BT, Kim EM, Kwon H, Kang JH, Park JH, et al. Diagnosis of obesity: 2022 update of clinical practice guidelines for obesity by the Korean society for the study of obesity. J Obesity Metab Syndr. 2023;32(2):121\u20139.","journal-title":"J Obesity Metab Syndr"},{"key":"2498_CR19","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyad097","author":"T Takeda","year":"2023","unstructured":"Takeda T, Okamoto T, Sasaki T, Hirai T, Ishitsuka T, Yamada M, et al. The impact of osteosarcopenia in patients with unresectable or recurrent biliary tract cancer receiving palliative chemotherapy. Jpn J Clin Oncol. 2023. https:\/\/doi.org\/10.1093\/jjco\/hyad097.","journal-title":"Jpn J Clin Oncol"},{"issue":"4","key":"2498_CR20","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1093\/jjco\/hyaa247","volume":"51","author":"T Takeda","year":"2021","unstructured":"Takeda T, Sasaki T, Mie T, Furukawa T, Yamada Y, Kasuga A, et al. The impact of body composition on short-term outcomes of neoadjuvant chemotherapy with gemcitabine plus S-1 in patients with resectable pancreatic cancer. Jpn J Clin Oncol. 2021;51(4):604\u201311.","journal-title":"Jpn J Clin Oncol"},{"issue":"10","key":"2498_CR21","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1111\/hepr.12774","volume":"46","author":"H Nishikawa","year":"2016","unstructured":"Nishikawa H, Shiraki M, Hiramatsu A, Moriya K, Hino K, Nishiguchi S. Japan Society of Hepatology guidelines for sarcopenia in liver disease (1st edition): recommendation from the working group for creation of sarcopenia assessment criteria. Hepatol Res J Jpn Soc Hepatol. 2016;46(10):951\u201363.","journal-title":"Hepatol Res J Jpn Soc Hepatol"},{"issue":"2","key":"2498_CR22","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1097\/MPA.0000000000000446","volume":"45","author":"H Imaoka","year":"2016","unstructured":"Imaoka H, Mizuno N, Hara K, Hijioka S, Tajika M, Tanaka T, et al. Evaluation of modified Glasgow prognostic score for pancreatic cancer: a retrospective cohort study. Pancreas. 2016;45(2):211\u20137.","journal-title":"Pancreas"},{"key":"2498_CR23","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.cca.2018.01.024","volume":"479","author":"Y Zhou","year":"2018","unstructured":"Zhou Y, Wei Q, Fan J, Cheng S, Ding W, Hua Z. Prognostic role of the neutrophil-to-lymphocyte ratio in pancreatic cancer: a meta-analysis containing 8252 patients. Clin Chim Acta. 2018;479:181\u20139.","journal-title":"Clin Chim Acta"},{"issue":"3","key":"2498_CR24","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Y Kanda","year":"2013","unstructured":"Kanda Y. Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics. Bone Marrow Transpl. 2013;48(3):452\u20138.","journal-title":"Bone Marrow Transpl"},{"issue":"4","key":"2498_CR25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195118","volume":"13","author":"J Kang","year":"2018","unstructured":"Kang J, Lee SH, Son JH, Lee JW, Choi YH, Choi JH, et al. Body mass index and weight change during initial period of chemotherapy affect survival outcome in advanced biliary tract cancer patients. PLoS ONE. 2018;13(4):e0195118.","journal-title":"PLoS ONE"},{"issue":"1","key":"2498_CR26","doi-asserted-by":"publisher","first-page":"5845","DOI":"10.1038\/s41598-021-85186-6","volume":"11","author":"K Yugawa","year":"2021","unstructured":"Yugawa K, Itoh S, Iseda N, Kurihara T, Kitamura Y, Toshima T, et al. Obesity is a risk factor for intrahepatic cholangiocarcinoma progression associated with alterations of metabolic activity and immune status. Sci Rep. 2021;11(1):5845.","journal-title":"Sci Rep"},{"issue":"8","key":"2498_CR27","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1007\/s00535-024-02124-9","volume":"59","author":"S Takaoka","year":"2024","unstructured":"Takaoka S, Hamada T, Takahara N, Fukuda R, Hakuta R, Ishigaki K, et al. Body mass index and survival among patients with advanced biliary tract cancer: a single-institutional study with nationwide data-based validation. J Gastroenterol. 2024;59(8):732\u201343.","journal-title":"J Gastroenterol"},{"issue":"1","key":"2498_CR28","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.cmet.2019.10.013","volume":"31","author":"C Zhang","year":"2020","unstructured":"Zhang C, Yue C, Herrmann A, Song J, Egelston C, Wang T, et al. STAT3 activation-induced fatty acid oxidation in CD8(+) T effector cells is critical for obesity-promoted breast tumor growth. Cell Metab. 2020;31(1):148-61.e5.","journal-title":"Cell Metab"},{"issue":"6","key":"2498_CR29","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1002\/oby.23108","volume":"29","author":"MD Sanchez-Pino","year":"2021","unstructured":"Sanchez-Pino MD, Gilmore LA, Ochoa AC, Brown JC. Obesity-associated myeloid immunosuppressive cells, key players in cancer risk and response to immunotherapy. Obes Silver Spring. 2021;29(6):944\u201353.","journal-title":"Obes Silver Spring"},{"issue":"1","key":"2498_CR30","doi-asserted-by":"publisher","first-page":"152","DOI":"10.7150\/ijbs.84890","volume":"20","author":"J Gong","year":"2024","unstructured":"Gong J, Gao X, Ge S, Li H, Wang R, Zhao L. The role of cGAS-STING signalling in metabolic diseases: from signalling networks to targeted intervention. Int J Biol Sci. 2024;20(1):152\u201374.","journal-title":"Int J Biol Sci"},{"issue":"1","key":"2498_CR31","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1186\/s13045-020-00916-z","volume":"13","author":"M Jiang","year":"2020","unstructured":"Jiang M, Chen P, Wang L, Li W, Chen B, Liu Y, et al. cGAS-STING, an important pathway in cancer immunotherapy. J Hematol Oncol. 2020;13(1):81.","journal-title":"J Hematol Oncol"},{"issue":"1","key":"2498_CR32","first-page":"303","volume":"44","author":"Z Li","year":"2025","unstructured":"Li Z, Zheng W, Liu Y, Cao R, Wei J, Jia H. Bridging innate and adaptive tumor immunity: cGAS-STING pathway activation to potentiate immune checkpoint blockade. J Exp Clin Cancer Res CR. 2025;44(1):303.","journal-title":"J Exp Clin Cancer Res CR"},{"key":"2498_CR33","doi-asserted-by":"publisher","DOI":"10.1042\/ebc20253006","author":"B Yue","year":"2025","unstructured":"Yue B, Gao W, Lovell JF, Jin H, Huang J. The cGAS-STING pathway in cancer immunity: dual roles, therapeutic strategies, and clinical challenges. Essays Biochem. 2025. https:\/\/doi.org\/10.1042\/ebc20253006.","journal-title":"Essays Biochem"},{"issue":"1","key":"2498_CR34","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-024-01037-w","volume":"23","author":"L Zhang","year":"2024","unstructured":"Zhang L, Wang K, Liu R, Kuang T, Chen C, Yao F, et al. Body composition as a prognostic factor in cholangiocarcinoma: a meta-analysis. Nutr J. 2024;23(1):145.","journal-title":"Nutr J"},{"key":"2498_CR35","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.01581","volume":"10","author":"BM Lee","year":"2020","unstructured":"Lee BM, Cho Y, Kim JW, Jeung HC, Lee IJ. Prognostic significance of sarcopenia in advanced biliary tract cancer patients. Front Oncol. 2020;10:1581.","journal-title":"Front Oncol"},{"issue":"9","key":"2498_CR36","doi-asserted-by":"publisher","first-page":"5156","DOI":"10.1016\/j.clnu.2021.08.003","volume":"40","author":"J Han","year":"2021","unstructured":"Han J, Tang M, Lu C, Shen L, She J, Wu G. Subcutaneous, but not visceral, adipose tissue as a marker for prognosis in gastric cancer patients with cachexia. Clin Nutr. 2021;40(9):5156\u201361.","journal-title":"Clin Nutr"}],"container-title":["Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-026-02498-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00535-026-02498-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-026-02498-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T06:12:32Z","timestamp":1786687952000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00535-026-02498-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":36,"alternative-id":["2498"],"URL":"https:\/\/doi.org\/10.1007\/s00535-026-02498-y","relation":{},"ISSN":["0944-1174","1435-5922"],"issn-type":[{"value":"0944-1174","type":"print"},{"value":"1435-5922","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"assertion":[{"value":"26 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All authors declare no conflict of interest for this article.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}