ArticleWorld journal of surgery2026
Does Surgical Approach Influence Benchmark Attainment in Intrahepatic Cholangiocarcinoma?
Article in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Does Surgical Approach Influence Benchmark Attainment in Intrahepatic Cholangiocarcinoma?World journal of surgery · 2026Article
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39 authors.
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Abstract
backgroundIntrahepatic cholangiocarcinoma (ICC) is a rare malignancy with rising incidence and poor prognosis. Surgical resection remains the only curative option, with outcomes driven by R0 margins and lymphadenectomy (LND). While open liver resection (OLR) is standard, laparoscopic (LLR) and robotic liver resection (RLR) are increasingly used, with concerns about their oncologic adequacy.
objectiveTo assess the association between composite surgical benchmark attainment (R0 + LND) and short- and long-term outcomes after ICC resection, stratified per surgical approach.
methodsA retrospective multicenter analysis was conducted including 240 patients treated from 2010 to 2024. The primary endpoint was achievement of both R0 resection and LND. Secondary endpoints included 90-day mortality, overall (OS), and disease-free survival (DFS).
resultsAmong the 240 included patients 38.8% met surgical benchmarks (R0 + LND), with rates varying by approach: OLR 51.1%, RLR 44.4%, and LLR 14.5% (p < 0.001). 90-day mortality was 5.0% (12/240) overall, with no significant difference between surgical approaches (p = 0.219). One and 3-year overall survival was 79%/30% for OLR, 95%/89% for LLR, and 90%/81% for RLR (p < 0.001). Multivariable analysis identified tumor multiplicity as an independent predictor of mortality (HR = 2.18, p = 0.003), while LLR was independently protective (HR = 0.15, p < 0.001); RLR showed a non-significant protective trend.
conclusionAlthough OLR and RLR more frequently met oncological benchmark criteria, only LLR was independently associated with improved overall survival, highlighting a potential disconnect between benchmark adherence and long-term outcomes in ICC.
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