Matsuda T, Umeda Y, Matsuda T, et al. - Researchers sought to discover an immune-nutritional index (INI) for preoperative prediction of complications in patients undergoing surgical resection for intrahepatic cholangiocarcinoma (ICC). They retrospectively studied multi-institutional data of 316 patients who had received surgical treatment for ICC. They compared areas under the receiver operating characteristic curve among several INIs, and found that the prognostic nutritional index (PNI) displayed the highest predictive value for severe complications. In multivariate analysis, the following were revealed as independent risk factors for severe complications: PNI <  50, hilar lesion, and long operation time. Seemingly, preoperative PNI affords not only a beneficial INI correlating with postoperative severe complications but also a prognostic indicator for ICC.