{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T04:17:33Z","timestamp":1744431453839,"version":"3.40.4"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to evaluate the outcomes and role of lymphadenectomy in hypervascular intrahepatic cholangiocarcinoma (ICC) quantified using the arterial phase of contrast\u2010enhanced computed tomography (CT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with mass\u2010forming (MF) or predominantly MF type ICC who underwent surgical resection from 2000 to 2019 were retrospectively analyzed. Using the image of the late arterial phase, CT\u2010vascularity was calculated by dividing the CT value of the tumor (Hounsfield units) with that of the liver parenchyma. According to the CT\u2010vascularity, patients were divided into hypervascular (CT\u2010vascularity\u00a0&gt;\u00a01) and non\u2010hypervascular (CT\u2010vascularity\u00a0\u2264\u00a01) groups. Clinicopathologic features and survival outcomes were compared between the two groups. Further, the prognostic impact of lymphadenectomy was assessed in the hypervascular group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 135 patients with MF\u2010ICC, the hypervascular group, and non\u2010hypervascular group comprised 47 (34.8%) and 88 patients (65.2%), respectively. The hypervascular group displayed clinical features typically associated with hepatocellular carcinoma (HCC) (i.e., viral hepatitis or history of HCC) and less aggressive tumor characteristics such as lower proportions of regional lymph node metastasis. The overall survival (OS) and recurrence\u2010free survival (RFS) of the hypervascular group were significantly better than those of the non\u2010hypervascular group (all, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), and these results were retained after adjusting for known prognostic factors. Further, implementation of lymphadenectomy was not associated with benefit for OS and RFS in the hypervascular group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.819, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.912).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hypervascular ICC itself represents a favorable prognosis, and there is a possibility of omitting lymphadenectomy in this subgroup.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12476","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T06:30:13Z","timestamp":1736317813000},"page":"708-716","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes and Role of Lymphadenectomy in Hypervascular Intrahepatic Cholangiocarcinoma Based on CT\u2010Vascularity"],"prefix":"10.1002","volume":"49","author":[{"given":"Xuefeng","family":"Li","sequence":"first","affiliation":[{"name":"Department of Surgery Graduate School of Medicine Kyoto University  Kyoto 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