A novel grading system combining CA19-9, CA125, and CEA significantly improves prognostic accuracy for intrahepatic cholangiocarcinoma patients post-surgery.

• In a study of 535 patients, the combined 3c grade correlated with overall survival and recurrence-free survival, outperforming individual markers (p < 0.001).
• Tumor size and lymph node metastasis distinguished between 3c grade groups (p = 0.006).

This model offers surgeons critical insights for preoperative risk assessment and tailored treatment strategies for IC patients.