In intraductal papillary mucinous neoplasm-derived pancreatic cancer, removing at least 20 lymph nodes dramatically improves survival outcomes.

• The minimum required for accurate staging is 10 lymph nodes (p=0.040).
• Optimal lymphadenectomy of 20 nodes leads to a median overall survival of 80.3 months compared to 37.2 months with fewer nodes (p<0.001).

Prioritizing at least 20 lymph nodes during surgery enhances patient prognostics and decision-making for better outcomes.

• For pancreatoduodenectomy, 20 nodes are ideal (p<0.001) and for total pancreatectomy, 25 nodes should be targeted (p=0.008).