The following is a summary of “Role and Controversy of Pelvic Lymph Node Dissection in Prostate Cancer Treatment: A Focused Review,” published in the February 2024 issue of Surgery by Dong et al.

Pelvic lymph node dissection (PLND) is a routine adjunct to radical prostatectomy aimed at elucidating the lymphatic staging of prostate tumors through the meticulous removal of involved lymph nodes. This procedure holds paramount importance in clinical practice as it not only aids in guiding subsequent therapeutic interventions but also facilitates the eradication of metastatic foci, potentially conferring significant therapeutic advantages. However, despite its recognized importance, the utilization of PLND exhibits notable variations globally, reflecting the ongoing debates surrounding its therapeutic efficacy. While clinical guidelines offer disparate recommendations regarding its implementation, the pervasive uncertainty regarding PLND’s definitive oncological benefits persists due to the absence of robust, high-quality evidence supporting its superiority in improving patient outcomes. 

Nonetheless, the procedure’s undeniable role in prolonging the surgical duration and escalating the risk of complications underscores the imperative for a nuanced assessment of its utility in individual cases. Notwithstanding these concerns, PLND retains its status as the quintessential modality for lymph node staging in prostate cancer, furnishing invaluable staging insights unattainable through alternative techniques. This comprehensive review endeavors to delve into the multifaceted landscape of PLND, encompassing its clinical scope, divergent guideline perspectives, real-world implementation challenges, and impact on oncological and non-oncological outcomes. Moreover, it scrutinizes existing alternatives to PLND and delineates avenues for future research aimed at elucidating its precise role and optimizing its clinical utility in the management of prostate cancer.

 Source: wjso.biomedcentral.com/articles/10.1186/s12957-024-03344-2