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Minimum Number of Lymph Nodes Removed in Various Malignancies:

Minimum Number of Lymph Nodes Removed in Various Malignancies:

  • Breast: 10
  • Esophagus: 15
  • Stomach: 16
  • Small Bowel: 10
  • Colon: 12
  • Gastrinoma: 10
    • Sabiston Esophagus: 23 LN
    • NCCN Small Bowel: 8 LN

Key Procedures:

  • Trans Thoracic Esophagectomy: 23 LN
  • Ca Gall Bladder: 6 nodes
  • Perihilar Cholangiocarcinoma: 7 nodes
  • Selective Neck Dissection (SND): 10 nodes
  • Radical Neck Dissection (RND) or Modified Radical Neck Dissection (MRND)**: 15 nodes
  • Modified Radical Mastectomy (MRM): 10 LN
  • Breast Post Neoadjuvant Chemotherapy (NACT): Targeted Axillary Lymph Node Dissection (ALND)—3 LN

Stomach:

  • D1: Stations 1-7
  • D2: Stations 1-11
  • Stations 12-18: Not routinely removed anymore
  • Station 10: Not removed in D2 to preserve the spleen and pancreas (Bailey).

Updates in Lymph Node Dissection (LND):

  • Antrum Cancer: D2—LN spared, Stations 2, 10, 11.
  • Mid Gastric Cancer: D2—Stations 1-11.

Cardiac Cancer:

  • D2 Lymphadenectomy
  • Additionally:
    • Level 20: Esophagus hiatus LN
    • Tumor involving both Cardia and Esophagus: Additional LNs
      • 19: Infra-diaphragm
      • 20: Esophageal hiatus
      • 110: Lower esophagus
      • 111: Supra-diaphragmatic

Special Notes:

  • Breast Post NACT SLNB or Targeted Axillary Dissection with Dual Technique: Minimum 3 LN
    • As per SN-FNAC, SENTINA, ACOSOG Z1071.
  • Ca Gall Bladder: 6 nodes.
  • Perihilar Cholangiocarcinoma: 7 nodes.