Evidence map›Paper›PMID 41699355›Full record

ArticleAnnals of surgical oncology2026

Is Extended Lymphadenectomy in Biliary Tract Cancers Justified? A Retrospective Comparative Study of Gallbladder Cancer, Perihilar and Intrahepatic Cholangiocarcinoma.

Esther Giehl-Brown, Rajan Nikbakhsh, Sarah Bendig, Olga Radulova-Mauersberger, Johannes Schweipert, Jürgen Weitz, Carina Riediger

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Esther Giehl-BrownDepartment of Visceral, Thoracic, and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Rajan NikbakhshDepartment of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Sarah BendigDepartment of Visceral, Thoracic, and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Olga Radulova-MauersbergerDepartment of Visceral, Thoracic, and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Johannes SchweipertDepartment of Visceral, Thoracic, and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Jürgen WeitzDepartment of Visceral, Thoracic, and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Carina RiedigerDepartment of Visceral, Thoracic, and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. carina.riediger-schweipert@vinzenz.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe oncologic value of lymphadenectomy (LND) in biliary tract cancers (BTC) remains controversial. While guidelines recommend retrieval of ≥ 6 lymph nodes to ensure accurate staging, evidence for a therapeutic survival benefit is limited. PATIENTS AND

methodsWe retrospectively analyzed 253 consecutive resections for intrahepatic cholangiocarcinoma (iCCA), perihilar cholangiocarcinoma (pCCA), and gallbladder carcinoma (GBC) at a high‑volume hepatobiliary center from a prospectively maintained database (2013-2023). Patients were stratified into no (0 nodes), limited (1-5 nodes), and extended (≥ 6 nodes) LND. Postoperative morbidity, recurrence-free survival (RFS), and overall survival (OS) were assessed with uni- and multivariable models.

resultsLND was performed in 47% of patients and extended LND in 52.9%. Clavien-Dindo grade ≥ III complications occurred in 69.8% with LND ≥ 6 compared with 46.4% with LND1-5 and 41.8% with no LND (p < 0.001), with longer ICU and hospital stays and more septic and pulmonary events. On multivariable analysis, LND ≥ 6 was not an independent predictor of morbidity in the overall cohort, but in the subgroup of major resections (OR 2.79, 95% CI 1.121-6.955, p = 0.027). LND extent had no independent impact on OS or RFS.

conclusionsExtended LND was associated with a higher rate of postoperative complications and was an independent risk factor in patients undergoing major hepatectomy. However, no clear survival benefit was observed. These findings may suggest that the role of LND in BTC may be primarily diagnostic and that more selective, biology-driven approaches should be considered. Prospective studies are needed for validation.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaGallbladder NeoplasmsKlatskin TumorLymph Node ExcisionAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPostoperative ComplicationsPrognosisRetrospective StudiesSurvival RateBiliary tract cancerLymphadenectomyPostoperative morbidityRecurrence-free survivalStaging accuracy

Identifiers

PMID41699355
PMCPMC13337787

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.