Evidence map›Paper›PMID 42496892›Full record

ArticleSurgery today2026

Preoperative identification of high-risk patients for lymph node metastasis and the surgical dissection strategy in perihilar cholangiocarcinoma treated with curative-intent resection: a multicenter retrospective study.

Rui Jian, Hao-Yu Yang, Long-Fei Ren, Hong-Mei Jian, Peng Zhao, Jie Bai, Yan Jiang, Zhi-Xin Wang, Shu-Jie Pang, Xing-Chao Liu and 6 more

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Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

16 authors.

Rui Jian *Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Hao-Yu Yang *Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Long-Fei Ren *Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China.
Hong-Mei Jian *Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Peng ZhaoDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Jie BaiDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Yan JiangDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Zhi-Xin WangDepartment of Hepatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China.
Shu-Jie PangDepartment of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), Shanghai, China.
Xing-Chao LiuDepartment of Hepatobiliary Surgery, Sichuan Provincial People's Hospital, Chengdu, China.
Yu-Le LuoDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Rui GuoDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Hai-Su DaiDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China.
Zhi-Yu ChenDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China. chenzhiyu_umn@163.com.
Zhi-Peng LiuDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China. liuzhipeng1115@163.com.
Yi GongDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, No. 30, Gaotanyan Zheng Street, Shapingba, Chongqing, China. gongyitmmu@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLymph node metastasis (LNM) is a crucial prognostic indicator in perihilar cholangiocarcinoma (pCCA); however, preoperative tools for assessing LNM risk and determining the optimal extent of lymph node (LN) dissection remain limited. This study aimed to identify preoperative LNM predictors to guide regional LN dissections.

methodsThis multi-institutional retrospective study included 364 patients who underwent curative-intent pCCA resection (2020-2024). Multivariate logistic regression was used to identify independent predictors of preoperative LNM.

resultsEventually, 148 (40.7%) patients were pathologically LNM-positive. The independent preoperative predictors were age < 65 years (odds ratio [OR]: 1.634, P = 0.041), carbohydrate antigen 19-9 (CA19-9) ≥ 200 U/mL (OR: 1.868, P = 0.006), and imaging suspicion of LNM (OR: 2.863, P = 0.001). The high-risk group (imaging suspicion of LNM + CA19-9 ≥ 200 U/mL or age < 65 years) had a 66.0% pathological LNM rate, and ≥ 6 LN dissections significantly improved recurrence-free survival (RFS) compared to < 6 LN dissections (P = 0.002). The low-risk group (no risk factors) had a 23.5% pathological LNM rate, and no RFS difference was observed between the groups (P = 0.360).

conclusionsPreoperative imaging suspicion of LNM, elevated CA19-9 levels, and younger age can effectively identify the high-risk group with LNM in pCCA. Adequate LN dissection may be associated with improved recurrence-free survival in the high-risk group, suggesting a risk-stratified approach to the extent of LN dissection.

Indexed as

Lymph node metastasisPerihilar cholangiocarcinomaPreoperative predictive factorsPrognosisSurgery

Identifiers

PMID42496892

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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.