13/03/2021
The optimal treatment for intrahepatic cholangiocarcinoma remains liver resection plus lymph node dissection. However, despite this strong recommendation, lymphadenectomy is not routinely performed even in centers with expert surgeons. It is noteworthy that even the performance of lymphadenectomy for ICC may not affect the long term outcome. Nonetheless, lymphadenectomy may provide appropriate staging and will provide better adjuvant treatment thereafter.
Recently, we published our paper about who might not and might benefit from lymphadenectomy among patients with intrahepatic cholangiocarcinoma. We were able to categorize this patient into low risk and high risk for lymph node metastasis. Low risk patient may not benefit on lymphadenectomy while high risk patient may benefit on it.
Nowadays, I apply this to my patient and carefully categorize them into low risk and high. Recently, I performed liver resection plus lymph node dissection in a patient with ICC and high risk for lymph node metastasis. Tumor invaded/adherent to the vena cava thus primary repair of the vena cava was performed.
