Is Removing Lymph Nodes During Prostate Cancer Surgery Worth It?

When men have prostate cancer surgery, doctors sometimes remove nearby lymph nodes to check if the cancer has spread. This procedure is called pelvic lymph node dissection (PLND). But with new scans available, some experts are asking: do we still need to do PLND?

A new study followed more than 2,300 men who had prostate surgery. Some had their lymph nodes removed, and some did not. Researchers wanted to know if removing the lymph nodes helped stop the cancer from coming back or spreading.

After nearly four years of follow-up, the study found that overall, removing lymph nodes didn’t make a big difference in stopping the cancer from coming back. But there was a benefit for men with more serious cancer.

Men with high-risk prostate cancer lived longer without the cancer spreading when PLND was done. The same was true for men with intermediate-risk cancer. This suggests that for men with more aggressive cancer, removing lymph nodes during surgery might help keep the cancer from spreading.

For men with low-risk cancer, PLND may not be needed. But for others, it could be an important step in stopping the disease.