Podcast #313 · 30 Jun 2026
Approaches to Pelvic Lymph Node Dissection in Contemporary Prostate Cancer Surgery
- Prostate Cancer
- Radical Prostatectomy
- Lymphocele
- Prostate-Specific Membrane Antigen PET (PSMA PET)
- Urologic Oncology
- Urology
- Robotic Surgery
- Pelvic Lymph Node Dissection (PLND)
Is pelvic lymph node dissection still necessary in the era of PSMA PET imaging? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Kirsten Greene about how advanced imaging is influencing decisions for radical prostatectomy. They examine the strengths and limits of PSMA PET, the risks and benefits of PLND, and why careful, evidence-based decision-making remains essential.
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Dr. Greene explains her approach using MSK and Briganti nomograms alongside PSMA PET, noting that PET scans may miss small nodal disease and quality varies between centers. She emphasizes PLND as a staging tool rather than a curative procedure, outlining potential complications like lymphocele, lymphedema, vascular and ureteral injury, and neuropraxia. The episode highlights her shared decision-making process, surgical techniques for limiting risk, and the importance of multimodal planning, especially for PET-positive nodal disease. Dr. Greene also shares practical tips for lymphocele prevention, including the use of metal clips and the Lahey wrap.