Controversies over how, why and when pelvic lymph node dissection (PLND) should be performed persist. Available data suggest that a limited number of patients will experience a curative benefit from PLND, but it remains the most tried and tested diagnostic tool for staging. New techniques aim to improve noninvasive detection of diseased nodes.
References
Herr, H. W. et al. Surgical factors influence bladder cancer outcomes: a cooperative group report. J. Clin. Oncol. 22, 2781–2789 (2004).
Washington, S. L. III, Carroll, P. R. & Porten, S. P. in Cancer Metastasis Through the Lymphovascular System (eds Leong, S. P., Nathanson, S. D. & Zager, J. S.) 587–592 (Springer, 2022).
Voskuilen, C. S. et al. Diagnostic value of 18F-fluorodeoxyglucose positron emission tomography with computed tomography for lymph node staging in patients with upper tract urothelial carcinoma. Eur. Urol. Oncol. 3, 73–79 (2020).
Nguyen, D. P. et al. A specific mapping study using fluorescence sentinel lymph node detection in patients with intermediate- and high-risk prostate cancer undergoing extended pelvic lymph node dissection. Eur. Urol. 70, 734–737 (2016).
Schilham, M. G. M. et al. Head-to-head comparison of 68Ga-prostate-specific membrane antigen PET/CT and ferumoxtran-10-enhanced MRI for the diagnosis of lymph node metastases in prostate cancer patients. J. Nucl. Med. 62, 1258–1263 (2021).
Suarez-Ibarrola, R. et al. Is there an oncological benefit of performing bilateral pelvic lymph node dissection in patients with penile cancer and inguinal lymph node metastasis? J. Clin. Med. 10, 754 (2021).
Seisen, T. et al. Contemporary role of lymph node dissection at the time of radical nephroureterectomy for upper tract urothelial carcinoma. World J. Urol. 35, 535–548 (2017).
Gschwend, J. E. et al. Extended versus limited lymph node dissection in bladder cancer patients undergoing radical cystectomy: survival results from a prospective, randomized trial. Eur. Urol. 75, 604–611 (2019).
Lestingi, J. F. P. et al. Extended versus limited pelvic lymph node dissection during radical prostatectomy for intermediate- and high-risk prostate cancer: early oncological outcomes from a randomized phase 3 trial. Eur. Urol. 79, 595–604 (2021).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Related links
ClinicalTrials.gov PLND trials: https://beta.clinicaltrials.gov/search?patient=pelvic%20lymph%20node%20dissection&locStr=&distance=0&page=2
Rights and permissions
About this article
Cite this article
Ineichen, G.B., Burkhard, F.C. The future of pelvic lymph node dissection for urological malignancies. Nat Rev Urol 19, 575–576 (2022). https://doi.org/10.1038/s41585-022-00641-x
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41585-022-00641-x
- Springer Nature Limited