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Updated: Feb 4, 2026

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Pelvic Lymph Node Dissection during Radical Prostatectomy for Prostate Cancer: Harms versus Benefits.

Eva Donck1, Claudia Fede Spicchiale2, Tong Yang3

  • 1Department of Urology, ERN UROGEN Accredited Center, Ghent University Hospital, Ghent, Belgium, eva.donck@uzgent.be.

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|February 2, 2026
PubMed
Summary

Pelvic lymph node dissection (PLND) during radical prostatectomy (RP) increases complications without improving cancer recurrence rates. PLND primarily serves as a staging procedure for prostate cancer patients.

Keywords:
Lymph node dissectionLymphadenopathyMetastasisProstate cancerRadical prostatectomy

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Area of Science:

  • Urology
  • Oncology
  • Surgical Pathology

Background:

  • Prostate cancer patients undergoing radical prostatectomy (RP) may be at risk for regional lymph node invasion (LNI).
  • Pelvic lymph node dissection (PLND) is a procedure performed during RP to assess LNI.
  • The oncological benefits and potential harms of PLND require evaluation.

Purpose of the Study:

  • To evaluate the harms and oncological benefits of PLND during RP in prostate cancer patients.
  • To assess the impact of PLND on perioperative and oncologic outcomes.
  • To identify prognostic factors for biochemical recurrence.

Main Methods:

  • Retrospective study of prostate cancer patients undergoing RP between 2013 and 2023.
  • Comparison of outcomes between patients with (n=334) and without (n=161) PLND.
  • Use of Inverse Probability of Treatment Weighting (IPTW) for adjusted analysis.

Main Results:

  • Patients undergoing PLND had longer operation times and higher complication rates (58.3% related to PLND).
  • No significant differences in 4-year biochemical recurrence-free survival (BRFS), metastasis-free survival, or overall survival were observed between groups.
  • PLND did not significantly impact BRFS in the IPTW-adjusted cohort (HR 0.70, p=0.09).

Conclusions:

  • PLND during RP increases postoperative complications.
  • PLND does not improve short-term oncologic outcomes for prostate cancer.
  • PLND serves primarily as a staging procedure to guide management decisions.