ArticleThe Prostate2025
Impact of Pelvic Lymph Node Dissection on Early Oncological Outcomes in Intermediate-Risk Prostate Cancer Patients With Node-Negative PSMA PET.
Article in The Prostate, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Can pelvic lymph node dissection be spared in intermediate-risk prostate cancer patients with negative PSMA PET scan? A systematic review and diagnostic meta-analysis.Prostate cancer and prostatic diseases · 2026Pooled it
- Surgical Management of PSMA PET-Positive Lymph Nodes in Prostate Cancer.Current urology reports · 2026Review
- Changing Face of Radical Prostatectomy: A Nationwide Registry Study of Case-Mix, Surgical Evolution, and Outcomes.Cancers · 2026Article
- Pelvic lymph node dissection in prostate cancer, still no level 1 evidence of oncological benefit. Time to consider surveillance of negative pelvic lymph nodes on PSMA PET scan staging.Prostate cancer and prostatic diseases · 2026Article
- Impact of Negative Prostate-specific Membrane Antigen Positron Emission Tomography on the Decision to Perform a Pelvic Lymph Node Dissection During Radical Prostatectomy for Intermediate- to High-risk Prostate Cancer Patients: Results of an International Survey.European urology open science · 2026Article
- Observational
- PSMA-Targeted radiopharmaceuticals: from diagnosis to risk & quality of life.European journal of nuclear medicine and molecular imaging · 2025Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundPSMA PET/CT has previously shown superior performance in nodal staging of prostate cancer (PCa) and may be used to reduce the number of unnecessary PLND procedures. This study aims to assess the performance of PSMA PET/CT in nodal staging of intermediate-risk prostate cancer and to evaluate the effect of PLND on oncological outcomes of intermediate-risk prostate cancer patients with a negative PSMA PET/CT.
methodsA total of 308 patients with intermediate-risk PCa who underwent PSMA PET/CT for nodal staging between January 2014 and July 2024 were included in the study. Patients who underwent PLND had higher PSA and higher rates of PIRADS-5 and biopsy grade-group 3 disease. A 1:1 propensity score matching was performed to eliminate patient characteristics differences between groups and 140 patients were included in the final analysis. PSA persistence rates ( ≥ 0.1 ng/dL) and biochemical recurrence (BCR; ≥ 0.2 ng/dL) rates after RP were recorded. Kaplan-Meier curves were constructed to evaluate oncological outcomes. Log-rank test was utilized to compare oncological outcomes in patients with and without PLND.
resultsThe sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PSMA PET/CT on nodal staging were 53.3%, 95%, 47.1%, and 96.1%, respectively. The NPV of PSMA PET/CT in patients with biopsy GG3 disease (96.3%) was similar to those with biopsy GG2 disease (95.6%). The median follow-up after propensity score matching was 20.7 months. The 24-month BCR-free survival rates were 83.7% and 86.9% in the PLND-RP group and RP-only groups, respectively (p = 0.078).
conclusionsNPV of PSMA PET/CT in determining LNI was remarkable in patients with intermediate-risk PCa and PLND was found to have no impact on oncological outcomes. Therefore PLND may be omitted to decrease surgery-related complications in patients with intermediate-risk PCa a negative PSMA PET/CT for nodal staging.
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