{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T15:33:41Z","timestamp":1786635221027,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic performance of different staging modalities and oncological outcomes in patients with intermediate\u2010risk (IR) prostate cancer (PCa) undergoing radical prostatectomy (RP) with pelvic lymph node dissection (PLND).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Patients with IR PCa who underwent RP and PLND between 2015 and 2021 were retrospectively analysed. Patients who had received neoadjuvant hormone therapy were excluded. The effectiveness of computed tomography (CT), magnetic resonance imaging (MRI), and prostate\u2010specific membrane antigen\u2010positron emission tomography (PSMA\u2010PET) in detecting lymph node invasion (LNI) was assessed. Kaplan\u2013Meier analysis was used to evaluate biochemical recurrence\u2010free and metastasis\u2010free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8043 patients with IR PCa undergoing RP with PLND, 624 (7.8%) had LNI. PSMA\u2010PET was performed in 400 patients: six true positives, 40 false negatives, 14 false positives, and 340 true negatives. CT was used in 2079 patients: two true positives, 228 false negatives, seven false positives, and 1842 true negatives. MRI was performed in 148 patients: one true positive, 11 false negatives, and 136 true negatives, with no false positives. Sensitivity was highest for PSMA\u2010PET (13%), followed by MRI (8.3%) and CT (0.9%). Negative predictive values were 92.5% for MRI, 89.5% for PSMA\u2010PET, and 89% for CT. Patients with negative PSMA\u2010PET findings had significantly better biochemical recurrence\u2010free and metastasis\u2010free survival than those with suspicious findings on PSMA\u2010PET.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All evaluated staging modalities demonstrated limited sensitivity in detecting LNI in patients with IR PCa, including PSMA\u2010PET. Given the poor diagnostic performance of conventional imaging, such methods may be omitted in this setting. PSMA\u2010PET may still be considered selectively, as it provides modest sensitivity and prognostic value, although its role remains limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70155","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T02:09:20Z","timestamp":1769220560000},"page":"667-676","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic accuracy and outcomes of lymph node staging in intermediate\u2010risk prostate cancer"],"prefix":"10.1111","volume":"137","author":[{"given":"Christopher","family":"Kniep","sequence":"first","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital Hamburg Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Maurer","sequence":"additional","affiliation":[{"name":"Martini\u2010Klinik Prostate Cancer Centre University Hospital 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