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Gavriilidis et al. Hepatoma Res 2023;9:24 Hepatoma Research
DOI: 10.20517/2394-5079.2023.26

Review Open Access

The impact of lymphadenectomy on intrahepatic

cholangiocarcinoma management and prognosis: a
comprehensive review

2
1
Paschalis Gavriilidis , Natalie M. Bath , Timothy M. Pawlik 2
1
Department of Surgery, Colchester General Hospital, Colchester CO4 5JL, UK.
2
Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
Correspondence to: Prof. Timothy M Pawlik, MD, PhD, Department of Surgery, The Ohio State University Wexner Medical
Center, 395 W 12th Avenue, Columbus, OH 43210, USA. E-mail: tim.pawlik@osumc.edu
How to cite this article: Gavriilidis P, Bath NM, Pawlik TM. The impact of lymphadenectomy on intrahepatic cholangiocarcinoma
management and prognosis: a comprehensive review. Hepatoma Res 2023;9:23. https://dx.doi.org/10.20517/2394-
5079.2023.26

Received: 27 Mar 2023 First Decision: 4 May 2023 Revised: 15 Mar 2023 Accepted: 7 Jun 2023 Published: 12 Jun 2023

Academic Editors: Kenneth Siu Ho Chok, Matias A Avila Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
Intrahepatic cholangiocarcinoma (iCCA) is a rare liver cancer generally associated with poor patient outcomes.
Curative intent liver resection has been established as a standard treatment of care of resectable disease. However,
the role of lymphadenectomy, including the extent of resection and therapeutic value, continues to be an area of
controversy. The objective of this review was to highlight the role of lymph node dissection (LND) relative to
therapeutic value and prognosis in the surgical management of iCCA. A comprehensive review was performed
using MEDLINE/PubMed. Search terms included “intrahepatic cholangiocarcinoma”, “bile duct cancer”,
"lymphadenectomy”, “lymph node metastasis”, and "lymph node staging”. Treatment for iCCA should include an
R0 resection with regional lymphadenectomy. The prognostic and therapeutic value of regional lymphadenectomy
has been an increased area of research and debate. An increased number of lymph node metastases has correlated
with inferior overall survival versus lymph node-negative disease. In addition to surgical resection, regional
lymphadenectomy with the removal of at least six lymph nodes in the appropriate nodal basins based on primary
tumor location should be standard. The identification of lymph node metastasis provides additional important
information to guide providers in determining adjuvant therapy and surveillance strategies.

Keywords: Intrahepatic cholangiocarcinoma, lymph node dissection, neoadjuvant therapy, precision medicine

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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