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Outcomes were assessed using Kaplan-Meier curves, uni-and multivariable Cox regression, for biochemical recurrence-free survival (BCRFS) and biochemical failure-free survival (BCFFS). A propensity score matched analysis with Cox regression was undertaken matching 1:1 for potential confounders (age, iPSA, preoperative ISUP, cT stage at MRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups (PLND and no-PLND) had the same proportion of HR patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.0). The no-PLND group had a shorter median operative time by 50\u00a0min (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Conversely, the PLND group experienced significantly higher rates of 90-day high-grade complications (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and lymphoceles (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Over a median 20.5-month follow-up, no significant differences emerged in BCRFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.59) or BCFFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.76). Uni- and multivariable analyses adjusted for UCSF CAPRA and CAPRA-S variables, as well as propensity score matching, confirmed PLND was not associated with improved BCFFS. In patients who did recur, the sites of recurrence did not differ between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.62), with pelvic nodal recurrence being the most common site of recurrence in both groups (6, 50% for PLND and 3, 60% for no-PLND).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this short-term follow-up, performing PLND increased high-grade postoperative complications without providing a clear early oncological benefit regarding BCRFS, PSA persistence, or recurrence location.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06330-3","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T16:14:36Z","timestamp":1773245676000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The utility of pelvic lymph node dissection in PSMA-PET negative intermediate and high-risk prostate cancer patients undergoing radical prostatectomy"],"prefix":"10.1007","volume":"44","author":[{"given":"Giuseppe","family":"Reitano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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