SynthesisWorld journal of surgical oncology2025
Lymph node dissection in clinically node-negative intrahepatic cholangiocarcinoma: a systematic review and meta-analysis.
Synthesis in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Lymph Node Dissection in Biliary Tract Cancers: Time for a Rethink?Annals of surgical oncology · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLymph node dissection (LND) in clinically node-negative (cN0) intrahepatic cholangiocarcinoma (iCCA) remains controversial. While LND improves staging accuracy, its survival benefit in cN0-iCCA is uncertain.
methodsThis systematic review and meta-analysis followed PRISMA 2020 guidelines (PROSPERO registration: CRD420251050907). PubMed, Scopus, and Cochrane Library were searched through May 2025 for studies comparing curative-intent liver resection with or without LND in cN0-iCCA. Risk of bias was assessed using the Newcastle-Ottawa Scale, and meta-analysis was conducted using a random-effects model.
resultsFive retrospective studies comprising 1,290 patients (507 LND, 783 non-LND) were included. The pooled analysis showed a non-significant trend toward improved OS in the LND group (HR = 0.80, 95% CI: 0.56-1.15; I² = 77.17%). Subgroup analysis including only low-risk-of-bias studies (Newcastle-Ottawa Scale ≥ 7) demonstrated a significant survival benefit (HR = 0.71, 95% CI: 0.52-0.98; I² = 61.09%). For DFS, the pooled HR was 0.93 (95% CI: 0.63-1.38; I² = 74.77%). In the low-risk-of-bias subgroup, a trend toward improved DFS was observed (HR = 0.81, 95% CI: 0.51-1.28; I² = 67.29%), though not statistically significant. LND did not increase major postoperative complications (OR = 0.97, 95% CI: 0.68-1.38). However, considerable heterogeneity was observed across included studies (I² >70%), reflecting differences in patient selection, surgical extent, and definitions of clinically node-negative disease; therefore, these results should be interpreted with caution.
conclusionLND may improve survival in selected patients with cN0-iCCA without increasing postoperative risk. However, the evidence is limited by retrospective design and heterogeneity. Prospective studies are warranted to confirm these findings. No funding was received.
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