The Place Of Para-aortic Lymph Node Dissection (pand) In Gastric Cancer Surgery
Gastric cancer is a leading cause of death worldwide, with lymph node metastasis being a significant prognostic factor. D2 lymph node dissection is the standard surgical therapy, but para-aortic lymph node (PAN) metastasis is observed in advanced stomach cancer. Para-aortic lymph node dissection involves the removal of lymph nodes between the celiac axis and left renal vein, as well as between the left renal vein and inferior mesenteric artery. This procedure, also known as PAND or D3/R3 dissection, was adopted by Japanese surgeons in the 1980s after observing favorable results in survival rates. However, a prospective randomized study conducted between 1995-2001 showed no difference in 5-year survival rates between D2 and D2+PAND. Despite this, PAN metastasis rates range from 18-40%, making PAND a popular procedure.(AI)
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