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The prognostic impact of differentiation at the invasive front of biliary tract cancer
Author(s) -
Okubo Satoshi,
Mitsunaga Shuichi,
Kato Yuichiro,
Kojima Motohiro,
Sugimoto Motokazu,
Gotohda Naoto,
Takahashi Shinichiro,
Hayashi Ryuichi,
Konishi Masaru
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24946
Subject(s) - medicine , biliary tract cancer , biliary tract , oncology , gastroenterology , cancer , pathology , gemcitabine
Background 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 inv ) and tumor budding (Bud) in biliary tract cancer (BTC). Methods 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 inv grade (G) 3 and Bud foci ≥5 were found in 47% and 10%. Tumor with Dif inv G3 showed the high frequencies of Bud, vascular invasion (Ve) and nodal metastasis (LN) compared to tumor with Dif inv G1/2 (Bud: 21% vs 0%, Ve: 71% vs 50%, LN: 52% vs 36%). Multivariate analysis revealed that the independent predictors were Dif inv G3 (HR: 1.71), Bud foci ≥5 (HR: 2.14), Ve (HR: 1.56) and LN (HR: 2.59) in overall survival and were positive resection margin (HR: 1.71), Dif inv G3 (HR: 1.75), Ve (HR: 1.50), and LN (HR: 2.19) in relapse free survival. Conclusion Poor differentiation at the invasive front of tumor was associated with poor prognosis and early relapse in BTC patients.