{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T02:02:34Z","timestamp":1780452154126,"version":"3.54.1"},"reference-count":0,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathobiology"],"published-print":{"date-parts":[[2024]]},"abstract":"<b><i>Introduction:<\/i><\/b> Although tumor budding (TB) has been recognized as a representative adverse prognosticator in gastrointestinal malignancies, it is not well elucidated in distal extrahepatic bile duct carcinoma (DBDC). Herein, we investigated the prognostic significance of peritumoral (PTB) and intratumoral (ITB) budding according to the modified DBDC staging of the 8th edition of the American Joint Committee on Cancer. <b><i>Methods:<\/i><\/b> PTB and ITB were independently evaluated in a cohort of DBDC patients (<i>n<\/i> = 410) based on the 2016 International Tumor Budding Consensus Conference. <b><i>Results:<\/i><\/b> High levels of PTB (PTB<sup>High<\/sup>, \u2265 grade-2) and ITB (ITB<sup>High<\/sup>, \u2265 grade-3) were identified in 316 (77%) and 238 (58%) cases, respectively. In univariate analysis, PTB<sup>High<\/sup> and ITB<sup>High<\/sup>, larger size and sclerosing tumor growth pattern, higher histologic grade, extrapancreatic location, adenocarcinomas unrelated to intraductal papillary neoplasm of the bile duct, pancreatic, duodenal, and lymphovascular invasion, perineural invasion, cancer involvement of the bile duct resection margin, nodal metastasis, and higher T and N categories and disease stages were associated with shorter patient overall survival (OS) times. In multivariate analysis, PTB<sup>High<\/sup> and ITB<sup>High<\/sup> remained poor independent prognostic indicators of OS in DBDC patients. Specifically, ITB<sup>High<\/sup> could predict poor prognosis in patients with stage I (T1N0) DBDC. <b><i>Conclusions:<\/i><\/b> Both PTB<sup>High<\/sup> and ITB<sup>High<\/sup> were strong prognostic indicators in patients with DBDC. Thus, ITB could be used to predict worse prognoses in patients with DBDC, in which PTB is difficult to assess, especially for patients with stage I (T1N0) DBDC. <\/jats:p>","DOI":"10.1159\/000535847","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T14:53:57Z","timestamp":1703084037000},"page":"254-267","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic Significance of Intratumoral and Peritumoral Budding in Distal Extrahepatic Bile Duct Carcinoma"],"prefix":"10.1159","volume":"91","author":[{"given":"Sun-Young","family":"Jun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Mo","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soyeon","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2023,12,19]]},"container-title":["Pathobiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/pat\/article-pdf\/doi\/10.1159\/000535847\/4263123\/000535847.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/pat\/article-pdf\/doi\/10.1159\/000535847\/4263123\/000535847.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:02:00Z","timestamp":1745424120000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000535847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,19]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,8,7]]},"published-print":{"date-parts":[[2024,8,7]]}},"URL":"https:\/\/doi.org\/10.1159\/000535847","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.24865989","asserted-by":"subject"}]},"ISSN":["1015-2008","1423-0291"],"issn-type":[{"value":"1015-2008","type":"print"},{"value":"1423-0291","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,19]]}}}