Lymph node counts in the upper abdomen: Anatomical basis for lymphadenectomy in gastric cancer

The number of regional lymph nodes was determined in sites relevant to lymphadenectomy in gastric cancer in 30 cadavers. Tissue was cleared by dissolving fatty tissue, thus making lymph nodes with a diameter of at least 1 mm visible. All lymph node stations indicated by the Japanese Research Society for Gastric Cancer were studied. In stations 1–11 (corresponding with R2 resection) an average of 27 nodes (range 17–44 nodes) was found, whereas stations 1–16 (corresponding with R3 resection) showed an average of 43 nodes (range 25–64 nodes). These values are higher than those usually obtained from lymphadenectomy for gastric cancer. Striking individual differences in the total number of lymph nodes and the number of single stations was observed. The number of lymph nodes in these investigations are the normal anatomical values and serve as quality control of lymph node dissection in gastric carcinoma.