Evidence map›Paper›PMID 42289631›Full record

ArticleAnnals of surgical oncology2026

Tumor Burden Modifies the Prognostic Impact of Adequate Lymph Node Dissection in Patients Undergoing Curative-Intent Resection for Intrahepatic Cholangiocarcinoma.

Jun Kawashima, Kota Sahara, Kizuki Yuza, Yutaka Endo, François Cauchy, Federico Aucejo, Hugo P Marques, Rita Lopes, Andreia Rodriguea, Tom Hugh and 16 more

Abstract read
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

26 authors.

Jun KawashimaDepartment of Hepatobiliary and Pancreatic Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kota SaharaDepartment of Hepatobiliary and Pancreatic Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kizuki YuzaDepartment of Hepatobiliary and Pancreatic Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Yutaka EndoDepartment of Transplant Surgery, University of Rochester Medical Center, Rochester, NY, USA.
François CauchyDepartment of HPB Surgery and Liver Transplantation, Beaujon Hospital, Clichy, France.
Federico AucejoDepartment of Hepato-pancreato-biliary & Liver Transplant Surgery, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Hugo P MarquesDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
Rita LopesDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
Andreia RodrigueaDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
Tom HughDepartment of Surgery, The University of Sydney, Sydney, NSW, Australia.
Feng ShenDepartment of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China.
Shishir K MaithelDivision of Surgical Oncology, Winship Cancer Institution, Emory University, Atlanta, GA, USA.
Bas Groot KoerkampDepartment of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Irinel PopescuDepartment of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
Minoru KitagoDepartment of Surgery, Keio University, Tokyo, Japan.
Matthew J WeissDepartment of Surgery, Cancer Institute, Northwell Health, New Hyde Park, NY, USA.
Guillaume MartelDepartment of Surgery, University of Ottawa, Ottawa, ON, Canada.
Carlo PulitanoDepartment of Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Luca AldrighettiDepartment of Surgery, San Raffaele Hospital, Milan, Italy.
George PoultsidesDepartment of Surgery, Stanford University, Stanford, CA, USA.
Andrea RuzzenteDivision of General and Hepatobiliary Surgery, University of Verona, Verona, Italy.
Todd W BauerDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Ana GleisnerDepartment of Surgery, University of Colorado Denver, Denver, CO, USA.
Yuki HommaDepartment of Hepatobiliary and Pancreatic Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Itaru EndoDepartment of Hepatobiliary and Pancreatic Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. Tim.Pawlik@osumc.edu.ORCID http://orcid.org/0000-0002-7994-9870

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe oncologic impact of lymph node dissection (LND) for intrahepatic cholangiocarcinoma (iCCA) remains unclear. We hypothesized that the prognostic relevance of LND may vary according to tumor burden. Therefore, this study sought to evaluate the interaction between tumor burden and adequate LND among patients who underwent curative-intent resection for iCCA.

methodsPatients who underwent curative-intent liver resection for iCCA were identified from a large international multi-institutional database. Overall survival (OS) was evaluated using multivariable Cox regression models that included an interaction term between tumor burden score (TBS) and adequate LND.

resultsAmong 1,558 patients, 872 (56.0%) underwent LND and 322 (20.7%) underwent adequate LND, defined as retrieval of at least six lymph nodes. The median TBS was 6.1 (interquartile range [IQR] 4.1-8.6). On multivariable Cox regression analysis, a significant interaction was observed between TBS and adequate LND (hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.87-0.95, p < 0.001). Among 542 (34.8%) patients with TBS < 5.0, adjusted OS did not differ according to adequate LND status (HR 1.23, 95% CI 0.86-1.76, p = 0.265). In contrast, among 1,016 (65.2%) patients with TBS ≥ 5.0, adequate LND was associated with improved adjusted OS (HR 0.65, 95% CI 0.51-0.82, p < 0.001). Similar findings were observed for recurrence-free survival (RFS).

conclusionsThe prognostic relevance of adequate LND in patients undergoing curative-intent resection for iCCA appears to vary according to tumor burden. Adequate LND was associated with improved OS and RFS among patients with high TBS, but not among those with low TBS.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaHepatectomyLymph Node ExcisionTumor BurdenAgedFemaleFollow-Up StudiesHumansLymphatic MetastasisMaleMiddle AgedPrognosisRetrospective StudiesSurvival Rate

Identifiers

PMID42289631
PMCPMC13452779

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