Selective lymph node dissection in intrahepatic cholangiocarcinoma and combined hepatocellular cholangiocarcinoma may not impair oncological outcomes: a single-center retrospective cohort study

This study highlights the low compliance with the guidelines regarding lymph node dissection for intrahepatic cholangiocarcinoma in real-world settings. However, compared to lymphadenectomy with negative nodes, selective lymph node dissection based on clinical suspicion does not compromise the overall survival. These findings support individualized surgical approaches rather than universal lymphadenectomy protocols and challenge current guidelines mandating routine LND for all iCCA patients. Future guidelines should incorporate risk-stratified decision-making in lymph node management.