What's known on the subject? and What does the study add?
- Although high risk prostate cancer patients are most vulnerable to lymph node invasion, the definition of an extended pelvic lymph node dissection (PLND) for this cohort has remained vague. Additionally, there have been compelling data in the rectal cancer literature relating erectile dysfunction to the extent of PLND. Because of the similarities of the dissection templates, we investigated the impact of an extended PLND on urinary and sexual function.
- In the present study, we were able to determine a minimal lymph node yield necessary for accurate staging of high risk patients. Expanding the analysis to our entire cohort, we found worse potency outcomes in patients with an extended PLND, demonstrating that extended PLND may be counterproductive to the aims of nerve sparing in a lower risk population.