Brustia R, Langella S, Kawai T, et al. - Researchers sought to validate a preoperative risk score (PRS) proposed by Sasaki et al. to predict outcome of patients with intrahepatic cholangiocarcinoma treated by liver surgery. This risk score was based on preoperative albumin, neutrophil-to-lymphocytes-ratio, CA19-9 and tumor size. From 11 international HPB centers, they assessed 355 eligible patients with 174 deaths during the follow-up period. Similar to the original publication, the PRS exhibited mild discrimination and poor calibration performance in this external validation cohort. However, it was identified as capable in assisting the identification of different classes of risk and hence may allow better tailoring of a therapeutic strategy.