The role and controversy of pelvic lymph node dissection in prostate cancer treatment: a focused review

Baonan Dong ¹, Hui Zhan ², Ting Luan ¹

⁰Urology Surgery Department, The Second Affiliated Hospital of Kunming Medical University, 243 Dianmian Avenue, Wuhua District, Kunming, 650101, Yunnan, China.

World Journal of Surgical Oncology +

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February 25, 2024

View abstract on PubMed

Summary

Pelvic lymph node dissection (PLND) is crucial for prostate cancer staging, guiding treatment despite debated therapeutic benefits. This review examines its role, outcomes, and alternatives in prostate cancer management.

Area Of Science

Urology
Oncology
Surgical Pathology

Background

Pelvic lymph node dissection (PLND) is frequently performed during radical prostatectomy for prostate cancer.
Its primary role is to determine lymphatic staging and remove potential metastatic foci.

Purpose Of The Study

To review the scope, guideline perspectives, and implementation status of PLND.
To analyze oncologic and non-oncologic outcomes, alternatives, and future research needs for PLND in prostate cancer.

Main Methods

Review of clinical practice guidelines and existing literature on PLND.
Analysis of data regarding surgical outcomes, staging accuracy, and therapeutic impact.

Main Results

PLND provides essential staging information for prostate cancer, though high-quality evidence for superior oncologic outcomes is limited.
Implementation of PLND varies due to ongoing debates about its therapeutic value and recognized increases in surgical time and complications.

Conclusions

PLND remains the gold standard for lymph node staging in prostate cancer, offering critical information.
Further research is needed to clarify its precise therapeutic benefits and optimize its application in patient care.

Keywords:

Oncological outcomes Pelvic lymph node dissection Radical prostatectomy