ArticleAnnals of gastroenterological surgery2023
Clinical implications and optimal extent of lymphadenectomy for intrahepatic cholangiocarcinoma: A multicenter analysis of the therapeutic index.
Article in Annals of gastroenterological surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 12 citations in OpenAlex.
- Review
- Article
- Characteristics of "Very Early" Intrahepatic Cholangiocarcinoma Undergoing Liver Resection and Its Relationship With Carbohydrate Antigen 19-9.Journal of surgical oncology · 2025Article
- Hot Topics in the Surgical Treatment of Intrahepatic Cholangiocarcinoma: A Narrative Review of Current Managements.Cancers · 2025Review
- Intrahepatic Cholangiocarcinoma withSurgical case reports · 2025Article
- Surgical interpretation of the WHO subclassification of intrahepatic cholangiocarcinoma: a narrative review.Surgery today · 2025Review
- Intrahepatic cholangiocarcinoma with extensive intraductal extension of high-grade biliary intraepithelial neoplasia: a case report.Surgical case reports · 2023Article
- Clinical implications and optimal extent of lymphadenectomy for intrahepatic cholangiocarcinoma: A multicenter analysis of the therapeutic index.Annals of gastroenterological surgery · 2023Article
- How to interpret the results of clinical studies: "Multicenter cutting-edge study" or "real-world big data study"?Annals of gastroenterological surgery · 2023Article
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12 authors at 8 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Aims: Lymph node metastases (LNM) are associated with lethal prognosis in intrahepatic cholangiocarcinoma (ICC). Lymphadenectomy is crucial for accurate staging and hopes of possible oncological treatment. However, the therapeutic implications and optimal extent of lymphadenectomy remain contentious. Methods: To clarify the prognostic value and optimal extent of lymphadenectomy, the therapeutic index (TI) for each lymph node was analyzed for 279 cases that had undergone lymphadenectomy in a multi-institutional database. Tumor localization was divided into hilar lesions (n = 130), right peripheral lesions (n = 60), and left peripheral lesions (n = 89). In addition, the lymph node station was classified as Level 1 (LV1: hepatoduodenal ligament node), Level 2 (LV2: postpancreatic or common hepatic artery nodes), or Level 3 (LV3: gastrocardiac, left gastric artery, or celiac artery nodes). Results: Lymph node metastases were confirmed in 109 patients (39%). Five-y survival rates were 45.3% for N0 disease, 27.1% for LV1-LNM, 22.9% for LV2-LNM, and 7.3% for LV3-LNM ( Conclusion: The implications and extent of lymphadenectomy for ICC appear to rely on tumor location. In the peripheral type, the benefit of lymphadenectomy would be limited and dissection beyond LV1 should be avoided, while in the hilar type, lymphadenectomy up to LV2 could be recommended.
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