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nodes at the internal iliac area in 20% of the patients studied. Several studies have also reported improved survival following an extended template dissection.5,6 Nevertheless applying an extended template of lymphadenectomy is associated with an increased risk of morbidity, namely lymphocele, nerve and vessel injury. However, several reports associate worse potency outcomes following an E-PLND,7 these potency outcomes remain underreported. The manuscript has established that the robotic technique is not a prohibitive factor in performing E-PLND. It is essential to reach a consensus on the extent of a lymphadenectomy covering all primary-landing sites of prostate cancer. Furthermore, there is a need for randomized trials determining which patients would most benefit from an extended lymphadenectomy in high-risk prostate cancer.

Extended lymph node dissection for intermediate and high-risk prostate cancer: do we have all the evidence?