Does a PSMA-PET staging scan revealing no evidence of nodal disease obviate the benefit of an extended pelvic nodal dissection at time of prostatectomy? We don’t know, exactly. But here is an enlightening exploration of outcomes with (n = 1650) and without (n = 696) extended dissection with radical prostatectomy across multiple sites between 1996 to 2021. It turns out, those undergoing dissection had a significantly lower risk of subsequent metastatic disease for initially intermediate-risk (HR, 0.48) and high-risk (HR, 0.57) prostate cancer. This suggests, at least across a very broad population largely before the era of PSMA-PET staging, extended pelvic nodal dissection portends a therapeutic benefit. | Furrer, J Urol 2025
