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John W. Davis, MD, FACS, University of Texas MD Anderson Cancer Center, Houston, Texas, explores the role of pelvic lymph node dissection (PLND) in prostate cancer surgery. In this 13-minute presentation, Dr. Davis focuses on current practices, challenges, and outcomes. Dr. Davis highlights that lymph node dissection is frequently omitted in robotic prostatectomy procedures. He discusses the technical aspects of robotic lymph node dissection, emphasizing improved node yields with increased surgical expertise. Data from his experience show improved node retrieval with extended dissection, particularly in high-risk patients, where the positive node rate is significantly higher than in intermediate or low-risk groups. Dr. Davis underscores the prognostic but not necessarily therapeutic value of PLND, shown in systematic reviews and meta-analyses. Imaging advancements, particularly PSMA PET, enhance detection but may still miss micrometastases. While PLND has not demonstrated consistent oncologic benefit, it provides valuable staging information influencing adjuvant and salvage treatment decisions. He references current guidelines that support extended dissection in high-risk patients while omitting PLND in low-risk cases. Don't forget to join the GRU Community: https://grandroundsinurology.com/regi... Follow us on Twitter/X: https://x.com/GRUrology And like and subscribe to us here on YouTube!