AB015. SOH26AB_0270. Oncological and functional outcomes of extended pelvic lymph node dissection versus standard pelvic lymph node dissection in patients with prostate cancer: a systematic review
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AB015. SOH26AB_0270. Oncological and functional outcomes of extended pelvic lymph node dissection versus standard pelvic lymph node dissection in patients with prostate cancer: a systematic review

Aoife Tonna-Barthet1, Claire Doherty2, Zara Wadding3, Michael Newell4

1Department of Surgery, Tallaght University Hospital, Dublin, Ireland; 2Department of Surgery, The Royal London Hospital, London, UK; 3Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland; 4School of Medicine, University of Galway, Galway, Ireland

Background: The use of pelvic lymph node (LN) dissection alongside the radical prostatectomy is the most accurate method for staging in prostate cancer. However, the use of extended vs. standard LN dissection has been a longstanding area of debate. It has been postulated that extending the standard dissection can provide a therapeutic advantage. However, there have been concerns that there could be an increase in complications and worsened functional outcomes. This review aims to evaluate the oncological and functional outcomes of extended LN dissection vs. standard LN dissection in patients with prostate cancer.

Methods: A systematic review was performed by searching PubMed, Embase, MEDLINE, and Cochrane Register. Studies included reported on oncological or functional outcomes of patients undergoing extended pelvic LN dissection (ePLND) vs. standard pelvic LN dissection (sPLND). Outcomes extracted included clinical stage, operative approach, oncological outcome, and complications.

Results: A total of 702 studies were retrieved. After screening, a total of 12 papers were included, comprising of 10,267 patients. Median LN yield (sPLND: 11.6 LNs vs. ePLND: 17.7 LNs) and percentage of patients with positive LNs (sPLND: 5.2% vs. ePLND: 13.6%) were higher in the extended template. Biochemical recurrence rates were only decreased in patients deemed to have intermediate to high-risk disease. There was also minimal difference in complication rates of functional outcomes between groups (sPLND: 20% vs. ePLND: 24%).

Conclusions: It is clear from the results that extended LN dissection improves staging in prostate cancer. There is also improved oncological outcomes only in patients with intermediate to high-risk disease. There also is no significant difference in complication rate. Overall, given its staging benefits, decrease in biochemical recurrence rates, and comparable complication rate, ePLND is a viable choice over standard dissection in specific patient cohorts.

Keywords: Extended lymph node dissection (extended LN dissection); functional outcomes; oncological outcomes; prostate cancer; standard LN dissection

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab015
Cite this abstract as: Tonna-Barthet A, Doherty C, Wadding Z, Newell M. AB015. SOH26AB_0270. Oncological and functional outcomes of extended pelvic lymph node dissection versus standard pelvic lymph node dissection in patients with prostate cancer: a systematic review. Mesentery Peritoneum 2026;10:AB015.

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