The clinical value of lymph-node dissection in hepatitis B virus-associated intrahepatic cholangiocarcinoma

Hepatitis B virus-associated intrahepatic cholangiocarcinoma (HBV-ICC) exhibits distinct clinicopathological characteristics, and the role of lymph-node dissection (LND) in its management remains contentious. This study aims to evaluate the clinical value of LND in HBV-ICC. Clinicopathological data of 76 HBV-ICC patients treated at Pingxiang People's Hospital between 2015 and 2020 were analyzed. The cohort comprised 41 patients who underwent LND (LND[+] group) and 35 patients who did not (LND[-] group). Clinicopathological characteristics, perioperative outcomes, and survival were subjected to statistical analysis. The cohort had 1-, 2-, and 5- year overall survival (OS) rates of 85.5%, 27.6%, and 13.2%. The LND(+) group had significantly higher postoperative complications than the LND(-) group (P < .05). OS and postoperative recurrence rates did not significantly differ between the 2 groups (P = .71 and P = .44). Multivariate analysis showed that independent risk factors for poor prognosis after ICC resection included resection margin < 1cm (HR = 3.97 [2.11-7.48], P < .05), poor tumor differentiation (HR = 0.43 [0.19-0.95], P < .05), microvascular invasion (HR = 1.92 [0.98-3.78], P < .05), and nonanatomic hepatectomy (HR = 2.07 [1.13-3.81], P < .05). Resection margin, tumor differentiation, microvascular invasion, and anatomic hepatectomy were identified as independent prognostic factors in HBV-ICC. LND did not improve patient outcomes while potentially increasing complication risks, thus not recommended.