Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The future of pelvic lymph node dissection for urological malignancies

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.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. Herr, H. W. et al. Surgical factors influence bladder cancer outcomes: a cooperative group report. J. Clin. Oncol. 22, 2781–2789 (2004).

    Article  Google Scholar 

  2. 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).

  3. 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).

    Article  Google Scholar 

  4. 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).

    Article  Google Scholar 

  5. 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).

    CAS  Article  Google Scholar 

  6. 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).

    Article  Google Scholar 

  7. 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).

    CAS  Article  Google Scholar 

  8. 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).

    Article  Google Scholar 

  9. 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).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Gallus B. Ineichen.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Related links PLND trials:

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

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).

Download citation

  • Published:

  • Issue Date:

  • DOI:


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing