{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T05:20:15Z","timestamp":1775280015047,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":103,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Extended pelvic lymph node dissection (PLND) is recommended for intermediate\u2010 and high\u2010risk prostate cancer according to D'Amico risk classification, and there is evidence supporting its diagnostic value in staging. However, its therapeutic benefit remains unproven. We, therefore, aimed to evaluate the therapeutic significance of PLND in patients undergoing robot\u2010assisted radical prostatectomy (RARP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 329 patients with intermediate\u2010 or high\u2010risk prostate cancer (per D'Amico risk classification) who underwent RARP at two centers. Patients were divided into two groups: those who did not undergo lymph node dissection (no\u2010PLND group) and those who underwent an extended PLND (extended\u2010PLND group). After excluding patients who received neoadjuvant hormone therapy, 313 cases remained for analysis. Propensity score matching was performed to balance baseline characteristics, yielding 85 matched pairs. We compared prostate\u2010specific antigen progression\u2010free survival (PSA\u2010PFS) and overall survival (OS) between the matched groups. Perioperative outcomes (complications, console time, and blood loss) were also compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Kaplan\u2013Meier analysis showed no significant differences in PSA\u2010PFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.163) or OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.323) between the extended\u2010PLND and no\u2010PLND groups after matching. Similarly, when stratified by risk category, PSA\u2010PFS did not differ significantly between the two groups for either intermediate\u2010risk or high\u2010risk patients. Perioperative blood loss was similar between groups, but the no\u2010PLND group had a significantly lower overall complication rate (5.1% vs. 30.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and shorter median console time (160.2 vs. 230.5\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) than the extended\u2010PLND group. Notably, no Grade 3\u20134 complications (Clavien\u2013Dindo) occurred in the no\u2010PLND group, compared to 11 cases in the extended\u2010PLND group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In intermediate\u2010 and high\u2010risk prostate cancer, performing an extended PLND during RARP did not improve biochemical recurrence\u2010free or OS, suggesting minimal therapeutic benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70061","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T04:53:47Z","timestamp":1744692827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reevaluating the Therapeutic Role of Pelvic Lymph Node Dissection in Robot\u2010Assisted Radical Prostatectomy"],"prefix":"10.1111","volume":"18","author":[{"given":"Ryosuke","family":"Yamase","sequence":"first","affiliation":[{"name":"Department of Division of Systems Medicine and Gene Therapy Research Center for Genomic Medicine Saitama Medical University  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3581-5122","authenticated-orcid":false,"given":"Satoshi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kimitsu Chuo Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Urology Kimitsu Chuo Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Urology Yokohama Rosai Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyoshi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Urology Kimitsu Chuo Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maki","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Urology Yokohama Rosai Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.790183"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.23491"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2013.03.086"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2016.02.046"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-54261-4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000504"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.03.057"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-016-0606-8"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2015.07.009"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13683"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-019-01445-7"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.11.008"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1808424"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.10.044"},{"key":"e_1_2_9_16_1","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. 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