{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:20:26Z","timestamp":1786980026649,"version":"build-2736575974"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of extended (e-PLND) and super-extended pelvic lymph node dissection (se-PLND) during robot-assisted radical prostatectomy (RARP) by examining lymph node (LN) yield, complications, LN metastasis, and biochemical recurrence (BCR) incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between January 2016 and January 2020, 354 consecutive patients with &gt;\u20095% risk of lymph node involvement (LNI), as predicted by the Memorial Sloan Kettering Cancer Center nomogram, underwent RARP with (s)e-PLND at a high-volume center. The e-PLND involved removing fibrofatty lymphatic tissue around the obturator fossa, internal iliac region, and external iliac vessels. The se-PLND, performed at the discretion of the surgeons, also included lymph nodes from the pre-sacral and common iliac regions. Outcomes included histopathological findings by anatomical region; complications; and BCR incidence during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median LNI risk was 18% (IQR 9\u201331%). A median of 22 LN (IQR 16\u201328) were removed, with se-PLND yielding a higher number: 25 (IQR 20\u201332) compared to e-PLND: 17 (IQR 13\u201324) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). pN1 disease was detected in 22% of patients overall, higher in se-PLND (29%) than e-PLND (14%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Of metastatic LNs, 14% were situated outside the e-PLND template. Operation time was longer for se-PLND, but perioperative complications were similar between both groups. After a median follow-up of 24 months (IQR 7\u201333), BCR incidence was comparable between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared to standard extended pelvic lymph node dissection (PLND), super extended PLND increases lymph node yield and removal of metastatic deposits but does not contribute to progression free survival at mid-term.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-024-05321-6","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T12:15:01Z","timestamp":1730290501000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of complications and biochemical recurrence rates after (super) extended lymph node dissection during radical prostatectomy"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0505-4449","authenticated-orcid":false,"given":"Diederik J.H.","family":"Baas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas","family":"Isra\u00ebl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost M.S.","family":"de Baaij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henricus J.E.J.","family":"Vrijhof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Hoekstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Kusters-Vandevelde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F.A.","family":"Mulders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P.","family":"Michiel Sedelaar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik M.","family":"Somford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul A.","family":"van Basten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"issue":"2","key":"5321_CR1","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1002\/pros.22742","volume":"74","author":"G Gandaglia","year":"2014","unstructured":"Gandaglia G, Abdollah F, Schiffmann J et al (2014) Distribution of metastatic sites in patients with prostate cancer: a population-based analysis. Prostate 74(2):210\u2013216. https:\/\/doi.org\/10.1002\/pros.22742","journal-title":"Prostate"},{"issue":"3","key":"5321_CR2","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1097\/JU.0000000000000531","volume":"203","author":"LWM van Kalmthout","year":"2020","unstructured":"van Kalmthout LWM, van Melick HHE, Lavalaye J et al (2020) Prospective validation of Gallium-68 prostate specific membrane Antigen-Positron Emission Tomography\/Computerized Tomography for primary staging of prostate Cancer. J Urol 203(3):537\u2013545. https:\/\/doi.org\/10.1097\/JU.0000000000000531","journal-title":"J Urol"},{"issue":"11","key":"5321_CR3","doi-asserted-by":"publisher","first-page":"3929","DOI":"10.1007\/s00259-022-05827-4","volume":"49","author":"R Hermsen","year":"2022","unstructured":"Hermsen R, Wedick EBC, Vinken MJM et al (2022) Lymph node staging with fluorine-18 prostate specific membrane antigen 1007-positron emission tomography\/computed tomography in newly diagnosed intermediate- to high-risk prostate cancer using histopathological evaluation of extended pelvic node dissection as reference. Eur J Nucl Med Mol Imaging 49(11):3929\u20133937. https:\/\/doi.org\/10.1007\/s00259-022-05827-4","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"1","key":"5321_CR4","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.eururo.2023.03.001","volume":"84","author":"KM Chow","year":"2023","unstructured":"Chow KM, So WZ, Lee HJ et al (2023) Head-to-head comparison of the diagnostic accuracy of prostate-specific membrane Antigen Positron Emission Tomography and Conventional Imaging modalities for initial staging of Intermediate- to high-risk prostate Cancer: a systematic review and Meta-analysis. Eur Urol 84(1):36\u201348. https:\/\/doi.org\/10.1016\/j.eururo.2023.03.001","journal-title":"Eur Urol"},{"issue":"4","key":"5321_CR5","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.eururo.2019.01.049","volume":"77","author":"M Perera","year":"2020","unstructured":"Perera M, Papa N, Roberts M et al (2020) Gallium-68 prostate-specific membrane Antigen Positron Emission Tomography in Advanced prostate Cancer\u2014updated diagnostic utility, sensitivity, specificity, and distribution of prostate-specific membrane Antigen-avid lesions: a systematic review and Meta-analysis. Eur Urol 77(4):403\u2013417. https:\/\/doi.org\/10.1016\/j.eururo.2019.01.049","journal-title":"Eur Urol"},{"issue":"2","key":"5321_CR6","doi-asserted-by":"publisher","first-page":"214","DOI":"10.2967\/jnumed.120.245605","volume":"62","author":"S Klingenberg","year":"2021","unstructured":"Klingenberg S, Jochumsen MR, Ulh\u00f8i BP et al (2021) 68Ga-PSMA PET\/CT for Primary Lymph Node and Distant Metastasis NM Staging of high-risk prostate Cancer. J Nucl Med 62(2):214\u2013220. https:\/\/doi.org\/10.2967\/jnumed.120.245605","journal-title":"J Nucl Med"},{"key":"5321_CR7","doi-asserted-by":"publisher","unstructured":"Jansen BHE, Bodar YJL, Zwezerijnen GJC et al (2021) Pelvic lymph-node staging with 18F-DCFPyL PET\/CT prior to extended pelvic lymph-node dissection in primary prostate cancer - the SALT trial -. Eur J Nucl Med Mol Imaging 48(2):509\u2013520. https:\/\/doi.org\/10.1007\/s00259-020-04974-w","DOI":"10.1007\/s00259-020-04974-w"},{"issue":"3","key":"5321_CR8","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.eururo.2011.10.044","volume":"61","author":"A Briganti","year":"2012","unstructured":"Briganti A, Larcher A, Abdollah F et al (2012) Updated Nomogram Predicting Lymph Node Invasion in patients with prostate Cancer undergoing extended pelvic lymph node dissection: the essential importance of percentage of positive cores. Eur Urol 61(3):480\u2013487. https:\/\/doi.org\/10.1016\/j.eururo.2011.10.044","journal-title":"Eur Urol"},{"issue":"2","key":"5321_CR9","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.eururo.2011.01.016","volume":"60","author":"G Godoy","year":"2011","unstructured":"Godoy G, Chong KT, Cronin A et al (2011) Extent of pelvic lymph node dissection and the Impact of Standard Template Dissection on Nomogram Prediction of Lymph Node involvement. Eur Urol 60(2):195\u2013201. https:\/\/doi.org\/10.1016\/j.eururo.2011.01.016","journal-title":"Eur Urol"},{"issue":"5","key":"5321_CR10","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1111\/bju.13573","volume":"119","author":"JJ Tosoian","year":"2017","unstructured":"Tosoian JJ, Chappidi M, Feng Z et al (2017) Prediction of pathological stage based on clinical stage, serum prostate-specific antigen, and biopsy Gleason score: Partin tables in the contemporary era. BJU Int 119(5):676\u2013683. https:\/\/doi.org\/10.1111\/bju.13573","journal-title":"BJU Int"},{"issue":"2","key":"5321_CR11","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.eururo.2020.09.042","volume":"79","author":"N Mottet","year":"2021","unstructured":"Mottet N, van den Bergh RCN, Briers E et al (2021) EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate Cancer\u20142020 update. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 79(2):243\u2013262. https:\/\/doi.org\/10.1016\/j.eururo.2020.09.042","journal-title":"Eur Urol"},{"issue":"5","key":"5321_CR12","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.euo.2018.04.016","volume":"1","author":"TA Hueting","year":"2018","unstructured":"Hueting TA, Cornel EB, Somford DM et al (2018) External validation of models Predicting the Probability of Lymph Node involvement in prostate Cancer patients. Eur Urol Oncol 1(5):411\u2013417. https:\/\/doi.org\/10.1016\/j.euo.2018.04.016","journal-title":"Eur Urol Oncol"},{"issue":"2","key":"5321_CR13","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1111\/bju.15376","volume":"128","author":"TFW Soeterik","year":"2021","unstructured":"Soeterik TFW, Hueting TA, Israel B et al (2021) External validation of the Memorial Sloan Kettering Cancer Centre and Briganti nomograms for the prediction of lymph node involvement of prostate cancer using clinical stage assessed by magnetic resonance imaging. BJU Int 128(2):236\u2013243. https:\/\/doi.org\/10.1111\/bju.15376","journal-title":"BJU Int"},{"issue":"1","key":"5321_CR14","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.eururo.2016.12.003","volume":"72","author":"N Fossati","year":"2017","unstructured":"Fossati N, Willemse PPM, Van den Broeck T et al (2017) The benefits and Harms of different extents of Lymph Node Dissection during Radical Prostatectomy for prostate Cancer: a systematic review. Eur Urol 72(1):84\u2013109. https:\/\/doi.org\/10.1016\/j.eururo.2016.12.003","journal-title":"Eur Urol"},{"issue":"3","key":"5321_CR15","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1111\/bju.14066","volume":"121","author":"G Gandaglia","year":"2018","unstructured":"Gandaglia G, Zaffuto E, Fossati N et al (2018) Identifying candidates for super-extended staging pelvic lymph node dissection among patients with high-risk prostate cancer. BJU Int 121(3):421\u2013427. https:\/\/doi.org\/10.1111\/bju.14066","journal-title":"BJU Int"},{"issue":"1","key":"5321_CR16","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1111\/bju.14164","volume":"122","author":"M Altok","year":"2018","unstructured":"Altok M, Babaian K, Achim MF et al (2018) Surgeon-led prostate cancer lymph node staging: pathological outcomes stratified by robot-assisted dissection templates and patient selection. BJU Int 122(1):66\u201375. https:\/\/doi.org\/10.1111\/bju.14164","journal-title":"BJU Int"},{"issue":"4","key":"5321_CR17","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1016\/j.euo.2021.03.006","volume":"4","author":"KA Touijer","year":"2021","unstructured":"Touijer KA, Sjoberg DD, Benfante N et al (2021) Limited versus extended pelvic lymph node dissection for prostate Cancer: a Randomized Clinical Trial. Eur Urol Oncol 4(4):532\u2013539. https:\/\/doi.org\/10.1016\/j.euo.2021.03.006","journal-title":"Eur Urol Oncol"},{"issue":"5","key":"5321_CR18","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1016\/j.eururo.2020.11.040","volume":"79","author":"JFP Lestingi","year":"2021","unstructured":"Lestingi JFP, Guglielmetti GB, Trinh QD et al (2021) 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(5):595\u2013604. https:\/\/doi.org\/10.1016\/j.eururo.2020.11.040","journal-title":"Eur Urol"},{"issue":"4","key":"5321_CR19","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.euf.2017.02.014","volume":"4","author":"D Mitropoulos","year":"2018","unstructured":"Mitropoulos D, Artibani W, Biyani CS, Jensen JB, Roupr\u00eat M, Truss M (2018) Validation of the clavien\u2013dindo Grading System in Urology by the European Association of Urology Guidelines Ad Hoc Panel. Eur Urol Focus 4(4):608\u2013613. https:\/\/doi.org\/10.1016\/j.euf.2017.02.014","journal-title":"Eur Urol Focus"},{"issue":"6","key":"5321_CR20","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1016\/j.juro.2017.12.048","volume":"199","author":"AN Bernstein","year":"2018","unstructured":"Bernstein AN, Shoag JE, Golan R et al (2018) Contemporary incidence and outcomes of prostate Cancer Lymph Node metastases. J Urol 199(6):1510\u20131517. https:\/\/doi.org\/10.1016\/j.juro.2017.12.048","journal-title":"J Urol"},{"issue":"5","key":"5321_CR21","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/j.euo.2020.08.005","volume":"3","author":"G Marra","year":"2020","unstructured":"Marra G, Valerio M, Heidegger I et al (2020) Management of patients with node-positive prostate Cancer at Radical Prostatectomy and Pelvic Lymph Node Dissection: a systematic review. Eur Urol Oncol 3(5):565\u2013581. https:\/\/doi.org\/10.1016\/j.euo.2020.08.005","journal-title":"Eur Urol Oncol"},{"issue":"3","key":"5321_CR22","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/j.eururo.2012.06.057","volume":"63","author":"S Joniau","year":"2013","unstructured":"Joniau S, Van den Bergh L, Lerut E et al (2013) Mapping of pelvic lymph node metastases in prostate Cancer. Eur Urol 63(3):450\u2013458. https:\/\/doi.org\/10.1016\/j.eururo.2012.06.057","journal-title":"Eur Urol"},{"issue":"2","key":"5321_CR23","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.eururo.2021.05.006","volume":"80","author":"D Meijer","year":"2021","unstructured":"Meijer D, van Leeuwen PJ, Roberts MJ et al (2021) External validation and addition of prostate-specific membrane Antigen Positron Emission Tomography to the most frequently used nomograms for the prediction of pelvic lymph-node metastases: an International Multicenter Study. Eur Urol 80(2):234\u2013242. https:\/\/doi.org\/10.1016\/j.eururo.2021.05.006","journal-title":"Eur Urol"},{"issue":"2","key":"5321_CR24","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.eururo.2020.03.023","volume":"78","author":"G Gandaglia","year":"2020","unstructured":"Gandaglia G, Martini A, Ploussard G et al (2020) External validation of the 2019 Briganti Nomogram for the identification of prostate Cancer patients who should be considered for an extended pelvic lymph node dissection. Eur Urol 78(2):138\u2013142. https:\/\/doi.org\/10.1016\/j.eururo.2020.03.023","journal-title":"Eur Urol"},{"issue":"3","key":"5321_CR25","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/bju.15220","volume":"127","author":"M Oderda","year":"2021","unstructured":"Oderda M, Diamand R, Albisinni S et al (2021) Indications for and complications of pelvic lymph node dissection in prostate cancer: accuracy of available nomograms for the prediction of lymph node invasion. BJU Int 127(3):318\u2013325. https:\/\/doi.org\/10.1111\/bju.15220","journal-title":"BJU Int"},{"issue":"5","key":"5321_CR26","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1016\/j.euf.2021.11.003","volume":"8","author":"TFW Soeterik","year":"2022","unstructured":"Soeterik TFW, Wever L, Dijksman LM et al (2022) Clinical Trial Protocol for PSMA-SELECT: a Dutch National Randomised Study of prostate-specific membrane Antigen Positron Emission Tomography\/Computed Tomography as a Triage Tool for Pelvic Lymph Node Dissection in patients undergoing radical prostatectomy. Eur Urol Focus 8(5):1198\u20131203. https:\/\/doi.org\/10.1016\/j.euf.2021.11.003","journal-title":"Eur Urol Focus"},{"issue":"6","key":"5321_CR27","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1016\/j.eururo.2022.09.005","volume":"82","author":"MGM Schilham","year":"2022","unstructured":"Schilham MGM, Rijpkema M, Scheenen T et al (2022) How Advanced Imaging Will Guide Therapeutic strategies for patients with newly diagnosed prostate Cancer in the years to come. Eur Urol 82(6):578\u2013580. https:\/\/doi.org\/10.1016\/j.eururo.2022.09.005","journal-title":"Eur Urol"},{"issue":"3","key":"5321_CR28","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1111\/bju.13654","volume":"119","author":"MW Ball","year":"2017","unstructured":"Ball MW, Harris KT, Schwen ZR et al (2017) Pathological analysis of the prostatic anterior fat pad at radical prostatectomy: insights from a prospective series. BJU Int 119(3):444\u2013448. https:\/\/doi.org\/10.1111\/bju.13654","journal-title":"BJU Int"}],"container-title":["World Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-024-05321-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00345-024-05321-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-024-05321-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T16:25:21Z","timestamp":1735835121000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00345-024-05321-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,30]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["5321"],"URL":"https:\/\/doi.org\/10.1007\/s00345-024-05321-6","relation":{},"ISSN":["1433-8726"],"issn-type":[{"value":"1433-8726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,30]]},"assertion":[{"value":"7 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 October 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Medical Ethics Review Committee (CMO Arnhem-Nijmegen, registration number: 003-2020) confirmed that the Medical Research Involving Human Subjects Act does not apply to this study and the local ethics committee approved this study. Informed consent was not required because of the retrospective nature of this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"605"}}