Agostini-Vulaj D, Cates JMM, Bratton LE, et al. - In a Western cohort, researchers investigated if tumor budding (TB) in cholangiocarcinoma (CC) was associated with other clinicopathologic factors or with outcome. Employing International Tumor Budding Consensus Conference recommendations for colorectal carcinoma (CRC), they scored budding: the highest tumor bud count at the invasive tumor front in a 0.785 mm ² area was noted and stratified into Bd1 (0-4 buds), Bd2 (5-9 buds), and Bd3 (≥10 buds). This cohort comprised 54 (48%) extrahepatic CCs as well as 58 (52%) intrahepatic CCs. A correlation of worse disease-specific survival with budding score Bd2/Bd3 as well as with nodal disease was revealed in multivariate analysis. TB was found to be related to higher-grade disease in CC; a link between greater TB with poor disease-specific survival was also observed. Overall, beneficial information regarding patient prognosis may be provided by TB in CC, as in CRC.