ASO Author Reflections: Which Patients Benefit the Most From Lymphadenectomy During Resection for Intrahepatic Cholangiocarcinoma?

Excerpt

Despite unfavorable outcomes for patients with a diagnosis of intrahepatic cholangiocarcinoma (ICC), surgery remains the mainstay of potentially curative treatment for these patients.1 Although lymphadenectomy is essential to adequately stage the disease and decrease the risk of locoregional recurrence, the extent of lymphadenectomy and its related therapeutic benefit still remain a topic of debate.2 To this end, data are needed to define the potential therapeutic benefit as well as identify the group of patients who might benefit the most from lymph node dissection (LND) to guide treatment planning and improve long-term outcomes. By using the therapeutic index—a simple metric calculated by multiplying the frequency of lymph node metastasis (LNM) in a group of patients by the 3-year cancer-specific survival (CSS) rate of patients with LNM in this particular subgroup3—we sought to examine the survival benefit of lymphadenectomy for patients undergoing resection for ICC.4 …