Role of routine lymph node dissection alongside resection of intrahepatic cholangiocarcinoma: Systematic review and meta-analysis

Table 1 Summary of included studies

Ref.	Country	Design	LND (n)	Hepatectomy only (n)	Lymph nodes retrieved (n)	Percentage of LND patients with ≥ 6 nodes retrieved	Percentage of LND patients with positive lymph nodes	Outcomes	Estimate of hazard ratio for overall survival (95%CI)	Blood loss LND (ml)	Blood loss hepatectomy only
Uchiyama et al[38], 2011	Japan	Retrospective cohort	228	111	-	-	61	Neoadjuvant, adjuvant, tumour morphology	0.85 (0.64-1.12)	-	-
Kim et al[39], 2015	South Korea	Retrospective cohort	113	103	-	-		Disease free survival, neoadjuvant, adjuvant, tumour Morphology		-	-
									1.36 (0.94-1.96)
Hu et al[40], 2017	China	Retrospective cohort	73	349	-	-		Disease free survival, adjuvant	1.29 (0.90-1.85)	-	-
Miyata et al[41], 2017	Japan	Retrospective cohort	23	39	-	-	26.1	Disease free survival, tumour morphology, lymph node positivity	0.75 (0.41-1.37)	Mean: 765 ± 116	Mean: 552 ± 88
Xiao et al[42], 2017	China	Retrospective cohort	35	14	-	-		Tumour morphology	0.50 (0.26-0.98)	-	-
Wu et al[43], 2019	United States	Retrospective cohort	3290	2653	-	23.8	72.5	Neoadjuvant, adjuvant, lymph node metastasis, number of lymph Nodes harvested	0.76 (0.42-1.38)	-	-
Yoh et al[44], 2019	France and Japan	Retrospective cohort	132	60	-	-	16.7	Disease free survival, neoadjuvant, lymph node metastasis	0.71 (0.44-1.16)	-	-
Zhang et al[24], 2021	China	Retrospective cohort	53	25	-	-		Disease free survival	0.68 (0.39-1.19)	-	-
Hu et al[46], 2021	China	Retrospective cohort	177	55	-	37.3	40.1	Disease free survival, neoadjuvant, adjuvant, lymph node metastasis, number of lymph nodes harvested	0.91 (0.55-1.51)	Percentage > 300 ml: 52%	Percentage > 300 ml: 30.9%
Hu et al[45], 2021	United States	Retrospective cohort	1147	389	-	27.6	33.9	Lymph node metastasis, number of lymph nodes harvested	1.15 (1.02-1.30)
Kang et al[47], 2021	South Korea	Retrospective cohort	725	413	Mean: 5.9 (SD: 8.3)	-	40.4	Disease free survival, lymph node metastasis	1.13 (0.99-1.29)
Ke et al[48], 2021	China	Retrospective cohort	114	298	Median: 3.5 (IQR: 1–39)	28.3		Neoadjuvant, adjuvant, tumour morphology, number of lymph nodes harvested	0.66 (0.46-0.95)	Percentage > 400 ml: 25.5%	Percentage > 400 ml: 3.6%
Rafecas et al[49], 2021	Spain	Retrospective cohort	23	44	-	-	43.4	Neoadjuvant, adjuvant, lymph node metastasis	1.06 (0.58-1.92)
Umeda et al[50], 2022	Japan	Retrospective cohort	224	86	-	-		Adjuvant, lymph node metastasis	0.58 (0.40-0.85)	Median: 820 (IQR: 978)	Median: 525 (IQR: 773)
Yang et al[51], 2022	China	Retrospective cohort	67	80	Mean: 5 (Range: 3-9)	-		Neoadjuvant, adjuvant, lymph node metastasis	1.09 (0.54-2.20)	Median: 200.0 (200.0-400.0)	Median: 200.0 (100.0-400.0)

95%CI: 95% confidence interval; IQR: Interquartile range; LND: Lymph node dissection.