Extended vs. No Pelvic Lymph Node Dissection During Radical Prostatectomy. DISSECTION 2.0.

Inclusion Criteria:

• Age ≥ 18 years and life expectancy >15 years

• Any biopsy-proven WHO/ISUP grade groups III-V PCa

• High-risk prostate cancer defined as:

• Any biopsy-proven WHO/ISUP grade group III-V PCa or

• ISUP grade group II and PSA > 20 ng/ml

• PSMA-PET: negative staging for regional and distant metastasis

• multidisciplinary tumorboard recommendation for radical prostatectomy

• WHO performance status 0-1

• Adequate condition (ASA ≤ III) for general anesthesia and RP

Exclusion Criteria:

• ISUP grade group I PCa and cT1 or cT2 (MRI)

• cT4 (MRI) PCa

• PSMA-PET: positive staging for local and distant metastasis

• Any prior neoadjuvant, local or systemic treatment for PCa

• Previous PLND or pelvic radiotherapy

• Patients with a prior malignancy and treated with curative intention are eligible ifall treatment of that malignancy was completed at least 2 years before registrationand the patient has no evidence of disease at registration. Less than 2 years isacceptable for malignancies with low risk of recurrence and/or no late recurrence.

• Any other serious underlying medical, psychiatric, psychological, familial, orgeographical

• condition, which in the judgment of the investigator may interfere with the planned

• staging, treatment and follow-up, which affect patient compliance or place thepatient at

• high risk from treatment-related complications.

• Vulnerable men (participants incapable of judgment or participants under tutelage)will not be included in the study.