Role of Pelvic Lymph Node Dissection in the Surgical Treatment of Clinically Localized Prostate Cancer

A review of the literature indicates that an extended pelvic lymph node dissection is the best staging template for localized prostate cancer. A large randomized clinical trial showed a therapeutic benefit in reducing metastasis. However, the European Association of Urology recent guidelines have not yet taken a position in favor of extended pelvic lymph node dissection, citing, an increased morbidity associated with pelvic lymph node dissection. Level 1 evidence indicates the overall complication rates are in fact low. With the recent advances in molecular imaging, the future directions of pelvic lymph node dissection will likely be through intraoperative optical imaging.