Related Experiment Video
Updated: Apr 23, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Extended versus limited pelvic lymph node dissection and long-term outcomes in high-risk prostate cancer before
Georgios Daouacher1,2, Jessica Carlsson3, Pernilla Sundqvist3
1Faculty of Medicine and Health Örebro University Örebro Sweden.
Objectives:
To compare oncological outcomes after extended pelvic lymph node dissection (PLND) versus limited in patients with high-risk prostate cancer (PCa) undergoing curative external beam radiation therapy (EBRT).
Patients And Methods:
From 3627 men with PCa at a single centre between 2000 and 2013, 167 with high-risk, age ≤75, Gleason score 6-10, clinical stage T1-T3, PSA < 100 ng/ml, no distant metastases (M1) and node-negative at the obturator fossa, underwent PLND before curative EBRT. Of these, 90 received limited, and 77 underwent extended PLND. Mean follow-up (SD) was 14.9 yr (5.8) for the limited and 12.3 yr (3.3) for the extended PLND. Primary endpoint was biochemical recurrence (BCR), secondary M1, cancer-specific mortality (CSM), overall mortality (OM). HR, KM and Cox regression models adjusted for age and Cambridge prognostic group (CPG) score. RR, RD at 11 yr.
Results:
Extended PLND was associated with a significantly lower risk for BCR (HR: 0.51, 95% CI: 0.31-0.86, p = 0.01) (RR: 0.43, 95% CI: 0.26-0.69, p = 0.001), lower risk of M1 (HR: 0.22, 95% CI: 0.08-02.65, p = 0.006) (RR: 0.26, 95% CI: 0.09-0.73, p = 0.004) and lower CSM compared with limited PLND (HR: 0.31, 95% CI: 0.08-0.65 p = 0.035) (RR 0.27, 95% CI: 0.08-0.91, p = 0.028). OM did not differ significantly.
Conclusions:
Extended PLND prior to curative ERBT shows reductions in BCR, M1 and CSM long-term outcomes following extended versus limited PLND. Extended PLND can be considered in cases with high-risk PCa prior to curative EBRT.
