ArticleJournal of gastrointestinal oncology2026
Prognostic and therapeutic significance of microscopic tumor focus in combined hepatocellular-cholangiocarcinoma: a multicenter pathological study.
Article in Journal of gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Prognostic and therapeutic significance of microscopic tumor focus in combined hepatocellular-cholangiocarcinoma: a multicenter pathological study.Journal of gastrointestinal oncology · 2026Article
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8 authors.
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Abstract
Background: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer lacking personalized pathological parameters. Microscopic tumor focus (MTF), a microscopic intrahepatic metastatic pattern, remains poorly characterized, with unclear prognostic and therapeutic relevance in cHCC-CCA. In this study, the detailed significance of MTF in cHCC-CCA was investigated. Methods: A multicenter study included 310 cHCC-CCA patients who underwent curative-intent hepatectomy. MTF was further graded by its number/distribution (MTF 0: absence of MTF; MTF 1: 1-5 proximal MTFs; MTF 2: >5 proximal MTFs/≥1 distal MTFs) and subclassified by its histology (HCC-type MTF; CCA-type MTF; HCC + CCA-type MTF). Results: MTF was detected in 48.1% (149/310) of patients (MTF 1: 43.2%, MTF 2: 4.8%; HCC-type MTF: 17.7%; CCA-type MTF: 20.6%; HCC + CCA type MTF: 9.7%). MTF positivity correlated with poorer recurrence-free survival (RFS) (median time: 0.23 and 0.89 years), early RFS, and overall survival (OS) (median time: 1.53 and 2.95 years, all P<0.001), with MTF 2 and HCC + CCA-type MTF predicting the worst prognosis. For MTF-positive patients, surgical margin >0.1 cm improved RFS, early RFS, and OS, while surgical margin had no effect on MTF-negative patients. Age, tumor diameter, microvascular invasion and perineural invasion independently predicted MTF (area under the curve =0.704); MTF histology was an independent prognostic factor for RFS, early RFS, and OS (all Harrell's concordance index >0.7). Conclusions: This study standardized the definition of MTF and confirmed its prognostic value in cHCC-CCA. MTF stratification based on its number/distribution and histology enables more precise prognostic assessment. The presence of MTF could guide individualized selection of surgical margin.
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