Impact of resection margins and para-aortic lymph node metastases on recurrence patterns and prognosis in resectable pancreatic cancer – a long-term population-based cohort study

The Complexity of the Pancreatic Lymphatic System and the Key Role of Para-Aortic Lymph Node Metastasis in Pancreatic Cancer Prognosis Prediction: A Comprehensive Review

“…Kim et al conducted an extensive analysis focusing on treatment response, unveiling that patients harboring metastatic PALN who underwent postoperative chemotherapy exhibited substantially augmented disease-specific survival (DFS) rates (p = 0.0003) [27]. This finding resonates with the study by Sho et al, where a multivariate analysis conducted on patients with PALN metastasis unveiled that adjuvant chemotherapy and the number of metastatic PALNs were significantly correlated with long-term survival.…”

“…The PALN serves as a key filtering station for lymphatic fluid, facilitating the removal of waste products, pathogens, and cellular debris [26]. Due to their strategic location, these nodes are often examined in the context of cancer staging and metastasis assessment, particularly in abdominal and pelvic malignancies [27]. The status of the PALN is significant in understanding the potential spread of cancer cells and is instrumental in determining the appropriate course of treatment, such as surgery, radiation therapy, or systemic therapies.…”

“…In pancreatic cancer, the risk of PALN metastasis holds considerable clinical significance. Due to the intricate lymphatic drainage patterns in the abdominal region, pancreatic tumors are prone to spreading to this lymph node [27]. The PALN is a primary site for regional metastasis, providing a conduit for cancer cells to move beyond the primary tumor site.…”

“…The presence of metastasis in these nodes may influence treatment decisions, including considering more aggressive surgical interventions or targeted therapies [29]. Consequently, a thorough understanding of the risk and detection of PALN metastasis in pancreatic cancer is imperative for clinicians to devise effective and personalized treatment strategies that address the complexities of the disease and improve patient outcomes [24,27,30]. In pancreatic cancer, the risk of PALN metastasis holds considerable clinical significance.…”

“…In patients with pancreatic cancer, the identification of metastasis to PALN is widely acknowledged as a significant harbinger of adverse prognosis. However, the substantial frequency of such metastases has prompted considerable debate regarding their prognostic implications [27]. There exists ambiguity regarding whether all individuals with PALN involvement inevitably experience poor surgical outcomes, thus engendering discourse on the nature of this association-whether it is directly indicative of prognosis or merely a coincidental finding [30].…”