Perineural invasion is a prognostic factor in cholangiocarcinoma, regardless of anatomical location: A systematic review and meta-analysis

This comprehensive review and meta-analysis confirms that perineural invasion (PNI) predicts poorer overall and disease-free survival in cholangiocarcinoma, independent of tumor location. These results highlight the potential of PNI as a reliable histopathological marker to stratify postoperative risk and inform patient management. While most evidence is retrospective and smaller studies may overstate the effect, the consistent findings emphasize the need for large, multicenter prospective studies with standardized pathological assessment. Such efforts could facilitate the integration of PNI into prognostic models and support more individualized treatment strategies for patients with cholangiocarcinoma.