<p><strong> </strong><strong>Clinicians performing pelvic lymphadenectomy should perform an extended dissection, which improves staging accuracy compared to a limited dissection. <em>(Moderate Recommendation; Evidence Level: Grade: B)</em></strong></p>
Discussion
Discussion
<p>Using anatomic landmarks, PLND templates may be considered as follows:<sup>187</sup></p>
<ul>
<li>Limited = obturator fossa</li>
<li>Standard = limited plus external iliac lymph nodes</li>
<li>Extended = Standard plus internal iliac lymph nodes</li>
<li>Super-extended = Extended plus common iliac, presacral and/or other nodes</li>
</ul>
<p>Extended PLND results in higher lymph node counts as well as a greater positive lymph node yield.<sup>189, 191, 192, 198</sup><sup> </sup>While a more extensive lymph node dissection increases operative time as well as the risk of lymphocele,<sup>191</sup> the Panel believes that the demonstrated staging benefit supports that extended dissection should be performed for appropriately risk-selected patients undergoing PLND.</p>