Multifocal intrahepatic cholangiocarcinoma (ICC) is typically categorized as satellite lesions (SL) or intrahepatic metastasis (IM). Clinical staging and prognostic significance of multifocal ICC are a topic of debate.ICC patients with solitary or multifocal tumors undergoing curative-intent surgical resection were identified from an international multi-institutional database. SL and IM were classified according to distribution patterns. Among 1,064 patients included in the cohort, 358 had multifocal tumors that were defined as IM (n=95) or SL (n=263). Isolated AJCC Stage II of multifocal ICC disease was associated with shorter overall (OS)(median: 26.1 vs. 60.0 mo, p