Objectives and Background Lymph node (LN) metastasis is well recognized as a poor prognostic factor in intrahepatic cholangiocarcinoma (ICC), however, the efficacy of LN dissection for ICC remains unclear. We clarify a targeted papulation of ICC to evaluate it in this study. Methods A retrospective study of patients who underwent liver resection without the extrahepatic bile duct for ICC was conducted. The pattern of LN recurrence and the location of the primary tumor were evaluated. Results Between January 2003 and July 2014, 52 patients with ICC underwent surgery. Fourteen patients had LN recurrence, of whom 6 patients had LN recurrence only. Excluding patients with LN dissection at surgery, the primary tumor was limited to the perihilar surrounding area in patients with LN recurrence only. Recurrence rate in LNs was 50% in patients with primary tumors originating in the perihilar surrounding area, which was significantly higher than the rate of 13% in patients with primary tumors originating in other areas. Conclusions Primary tumors in the perihilar surrounding area have a high risk of LN recurrence. Regional lymphadenectomy combined with hepatectomy should be carried out in patients with ICC located in this area. The incidence of LN metastasis and the possibility of preventing LN recurrence could be effectively revealed by regional lymphadenectomy in selected patients.

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