title: Extent of pelvic lymph node dissection during radical cystectomy: is bigger better?
abstract: Pelvic lymph node dissection (PLND) is a standard component of radical cystectomy (RC) for bladder cancer. The optimal anatomic PLND template remains undefined. An extended PLND template can potentially improve survival through the eradication of micrometastatic disease and improved pathologic staging. However, this benefit could be compromised by a potential increase in perioperative complications and cost. Two randomized controlled clinical trials that will clarify this question are ongoing. Many important retrospective studies have provided insights into the optimal PLND extent. Here the authors review the key evidence that informs how urologists may tailor the PLND template during RC depending on patient and tumor characteristics.
authors.affiliation: The James Buchanan Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD.
authors.forename: Debasish
authors.initials: D
authors.lastname: Sundi
authors.affiliation: Department of Urology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Svatek
authors.affiliation: Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Nielsen
authors.affiliation: Department of Urology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Schoenberg
authors.affiliation: The James Buchanan Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD.
authors.forename: Trinity J
authors.initials: TJ
authors.lastname: Bivalacqua
keywords: Micrometastatic disease; Pelvic lymph node dissection; Radical cystectomy; Template