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@ARTICLE{GiehlBrown:309938,
      author       = {E. Giehl-Brown$^*$ and R. Nikbakhsh and S. Bendig and O.
                      Radulova-Mauersberger$^*$ and J. Schweipert$^*$ and J.
                      Weitz$^*$ and C. Riediger$^*$},
      title        = {{I}s {E}xtended {L}ymphadenectomy in {B}iliary {T}ract
                      {C}ancers {J}ustified? {A} {R}etrospective {C}omparative
                      {S}tudy of {G}allbladder {C}ancer, {P}erihilar and
                      {I}ntrahepatic {C}holangiocarcinoma.},
      journal      = {Annals of surgical oncology},
      volume       = {nn},
      issn         = {1068-9265},
      address      = {Berlin [u.a.]},
      publisher    = {Springer},
      reportid     = {DKFZ-2026-00387},
      pages        = {nn},
      year         = {2026},
      note         = {#NCTZFB9# / epub},
      abstract     = {The oncologic value of lymphadenectomy (LND) in biliary
                      tract cancers (BTC) remains controversial. While guidelines
                      recommend retrieval of ≥ 6 lymph nodes to ensure accurate
                      staging, evidence for a therapeutic survival benefit is
                      limited.We retrospectively analyzed 253 consecutive
                      resections for intrahepatic cholangiocarcinoma (iCCA),
                      perihilar cholangiocarcinoma (pCCA), and gallbladder
                      carcinoma (GBC) at a high‑volume hepatobiliary center from
                      a prospectively maintained database (2013-2023). Patients
                      were stratified into no (0 nodes), limited (1-5 nodes), and
                      extended (≥ 6 nodes) LND. Postoperative morbidity,
                      recurrence-free survival (RFS), and overall survival (OS)
                      were assessed with uni- and multivariable models.LND was
                      performed in $47\%$ of patients and extended LND in
                      $52.9\%.$ Clavien-Dindo grade ≥ III complications occurred
                      in $69.8\%$ with LND ≥ 6 compared with $46.4\%$ with
                      LND1-5 and $41.8\%$ with no LND (p < 0.001), with longer ICU
                      and hospital stays and more septic and pulmonary events. On
                      multivariable analysis, LND ≥ 6 was not an independent
                      predictor of morbidity in the overall cohort, but in the
                      subgroup of major resections (OR 2.79, $95\%$ CI
                      1.121-6.955, p = 0.027). LND extent had no independent
                      impact on OS or RFS.Extended LND was associated with a
                      higher rate of postoperative complications and was an
                      independent risk factor in patients undergoing major
                      hepatectomy. However, no clear survival benefit was
                      observed. These findings may suggest that the role of LND in
                      BTC may be primarily diagnostic and that more selective,
                      biology-driven approaches should be considered. Prospective
                      studies are needed for validation.},
      keywords     = {Biliary tract cancer (Other) / Lymphadenectomy (Other) /
                      Postoperative morbidity (Other) / Recurrence-free survival
                      (Other) / Staging accuracy (Other)},
      cin          = {DD04},
      ddc          = {610},
      cid          = {I:(DE-He78)DD04-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41699355},
      doi          = {10.1245/s10434-026-19192-1},
      url          = {https://inrepo02.dkfz.de/record/309938},
}