John W. Davis, MD, FACS, presented “Challenging the Role of Pelvic Lymph Node Dissection at Robotic Prostatectomy” during the 35th International Prostate Cancer Update conference on February 9, 2025, in Vail, Colorado.
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How to cite: Davis, John W. “Challenging the Role of Pelvic Lymph Node Dissection at Robotic Prostatectomy” February 9, 2025. Accessed Jan 2026. https://grandroundsinurology.com/challenging-the-role-of-pelvic-lymph-node-dissection-at-robotic-prostatectomy/
Challenging the Role of Pelvic Lymph Node Dissection at Robotic Prostatectomy – Summary
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.
About the 36th International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), is a multi-day, CME-accredited conference focused on new developments in prostate cancer treatment, diagnosis, and prevention. IPCU 36 will feature lectures, interactive discussions, panel roundtables, debates, and case reports. This conference is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer.
The goal of this educational program is to equip healthcare professionals involved in the diagnosis and treatment of prostate cancer with the up-to-date clinical knowledge and tools they need to best treat their patients. The program will discuss the treatment of prostate cancer from diagnosis to treating advanced and metastatic disease. The conference aims to give physicians exposure to a comprehensive review of treating prostate cancer patients and to give them a chance to discuss the issues with peers and experts. You can learn more about the conference here.
ABOUT THE AUTHOR
John W. Davis, MD, is a Professor of Urology and Director of the Urosurgical Prostate Program at the University of Texas MD Anderson Cancer Center in Houston. He received his BS in Biology at Davidson College in North Carolina in 1990. He then went on to earn his medical degree at the University of Virginia in 1994 and completed his residency training at Eastern Virginia Graduate School of Medicine in Norfolk. Dr. Davis had fellowship training in prostate cancer research in the Department of Microbiology and Molecular Cell Biology at Eastern Virginia Medical School, and received an American Foundation of Urologic Disease Scholar award for proteomic applications in prostate cancer biomarkers. He completed a Clinical Fellowship in Urologic Oncology at the MD Anderson Cancer Center, and a Fellowship in Laparoscopic Urology at Charité Hospital in Berlin, Germany, under the mentorship of Ingolf Tuerk.
Dr. Davis’ clinical interests include patients with urologic cancers, laparoscopic/robotic surgery, and general urology. His academic interests include quality of life after prostate cancer treatment, outcomes for robotic radical prostatectomy, high-risk prostate cancer trials, active surveillance for prostate cancer, and development of robotic surgical techniques for invasive bladder cancer. He has participated as an investigator in several Southwest Oncology Group and industry-sponsored clinical trials.
