Gastric cancer lymph node resection—the more the merrier?

The minimum number of examined lymph nodes for an accurate staging in gastric cancer patients is controversial. Since 1997 the UICC and AJCC de ne a minimum number of 15 examined lymph nodes for the pN0 status but over the last twenty years this has been challenged by several studies. Especially in advanced tumor stages a minimum number of 22–25 lymph nodes seem to provide better prognostic information and is reported to be significantly associated with prolonged survival and therefore for example examination of at least 25 lymph nodes is suggested in the German S3 guidelines (1-3).