This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Stomach & Duodenum, Subject name: Surgery
A subtotal gastrectomy with D2 dissection performed for Stage 3 gastric adenocarcinoma in the antrum includes ? 
Select and explain. 
A. More than 15 lymph nodes removed, B. Grossly negative margins of 2 cm, C. Billroth II reconstruction, D. Splenectomy
A: More than 15 lymph nodes removed
Answer: A: More than 15 lymph nodes removed 
Explanation: The standard operation for gastric cancer is radical subtotal gastrectomy, which entails ligation of the left and right gastric and gastro-epiploic aeries at the origin, as well as the en bloc removal of the distal 75% of the stomach, including the pylorus and 2 cm of duodenum, the greater and lesser omentum, and all associated lymphatic tissue. Generally, the surgeon strives for a grossly negative margin of at least 5 cm. In the absence of involvement by direct extension, the spleen and pancreatic tail are not removed. The operation is deemed an adequate cancer operation provided that tumour- free margins are obtained, >15 lymph nodes are removed, and all gross tumour is resected. Reconstruction is usually by Billroth I gastro-jejunostomy or Roux-en-Y reconstruction.