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The benefits of these high-risk operations are still debated. The objective of this study was to analyze short, long-term outcomes, and futility after surgery for LAICC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective single-center study on the 2013\u20132024 period was conducted. LAICC was defined as mass-forming intrahepatic tumors 5 cm or more in size with hepatic vein\/IVC contact or hepatic hilum contact or both and requiring extended liver resection (five segments or more). Futility was defined as deaths within 90 days or recurrence within 6 months of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      39 consecutive patients were analyzed, including (29) 74% women with a median age of 66 years (38\u201383 years). In 34 (88%) patients, a trisectionectomy (H145678 or H123458) was performed. Major vascular or biliary recontruction was required in 43.5% and 67%, respectively. Overall morbidity was 56%, with severe morbidity occurring in 8 (20%). The 90-day mortality was 5%. Median overall survival and recurrence-free survival was estimated at 58 and 23 months, respectively. Overall rate of futility was 15.4%. N+ has been shown to be the main factor affecting survival (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03 for overall survival and\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01 for recurrence-free survival). R1 resection had no impact of overall or recurrence-free survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study supports an aggressive surgical approach for LAICC. Anticipated R1 resection by necessity should not be considered a contraindication to surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-026-20034-3","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:56:06Z","timestamp":1782737766000},"page":"9991-10000","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Is R1 Extended Liver Resection for Locally Advanced Intrahepatic Cholangiocarcinoma Justified? 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