Sellers CM, et al. - Researchers undertook this retrospective cohort study to assess the value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) as prognostic biomarkers in intrahepatic cholangiocarcinoma (ICC) with a focus on viral hepatitis and liver status. Patients were selected from the institutional cancer registry. Baseline inflammatory markers were dichotomized at the median. Using Kaplan-Meier curves and Cox proportional hazard models, overall survival (OS) was evaluated. This study included overall 131 patients (median age 65 years, 52% male, 76% Caucasian). The median OS was 13.0 months. They found an association of increased NLR and SII, but not of dichotomized PLR, with decreased survival. Higher OS was reported in relation to low-NLR vs high-NLR in Child-Pugh class A (n = 94). In Child-Pugh class B/C (n = 28), no significant influence of NLR on median OS was evident. Overall, compared with PLR and SII, NLR exhibited a stronger influence as a prognostic marker in ICC. This survival influence was reduced in advanced liver disease.