442 and low-risk groups [75]. The Weight et al study of low-risk patients suggested that there was no difference in the 10-year actuarial biochemical recurrence-free outcomes between a low-risk cohort at the Cleveland Clinic and those who underwent lPLND and no PLND based on surgeon preference [76]. Berglund et al searched the Cancer of the Prostate Strategic Urologic Research Endeavor (CapSURE) observational database to find evidence that lPLND might impact biochemical recurrence after 5 years compared with no PLND [77]. Multivariate analysis demonstrated that performance of lPLND was not a predictor of bio- chemical recurrence in low-risk, intermediate-risk, or high-risk groups. 　Although many studies have examined the therapeutic role of PLND in treating prostate cancer, the question of whether low-risk patients benefit from PLND is still open. In contrast, men with intermediate- to high-risk prostate cancer appear more likely to benefit from ePLND, prognos- tically and perhaps even therapeutically. Greater nodal re- moval may also impact patient survival by the therapeutic effect of superior disease clearance, especially in patients with low-volume LN invasion or even in pN0 patients. In addition, removing as many nodes as possible should be the main objective of PLND for improving outcomes as well as detecting metastatic LNs. COMPLICATIONS OF PLND Complications of PLND include lymphocele, deep vein thrombosis, hematoma, pulmonary edema, ureteral in- jury, and obturator nerve injury. Complication rates for PLND range from 2% to 51% in different series [41]. The most commonly described complication is lymphocele [34,55]. Briganti et al compared the complication rates of extended (n=767) and limited (n=196) dissection and found that the lymphocele formation rates were 10.3% and 4.6%, respectively [41]. Lymphocele formation and prolonged length of stay were the only complications that were sig- nificantly higher in patients who underwent ePLND. Clark et al compared complication rates by randomly assigning 123 patients undergoing open radical prostatectomy to have ePLND on one side of the pelvis and lPLND on the oth- er [30]. They showed that a complication rate of 10% was attributable to PLND, with complications occurring three times more often with ePLND than with lPLND. In con- trast, Heidenreich et al demonstrated that the overall in- cidence of intra- and perioperative complications was sim- ilar for limited and extended PLND [31,78]. To avoid PLND-associated morbidity, the following suggestions have been made: (1) instead of using clips, which are often torn away during subsequent surgery, all lymphatics com- ing from the lower limb should be ligated; (2) all lymphatics lateral to the external artery should be saved; and (3) two drains should be placed on each side of the pelvis that are not removed until the total volume of secretion is ＜50 ml per day. In addition, injection of low molecular weight hep- arin into the arm and not the lower limb may help to reduce Korean J Urol 2011;52:437-445 Joung et al the incidence of lymphocele formation [79]. CONCLUSIONS Currently, PLND is the most accurate and reliable staging procedure for detecting LNI in prostate cancer. We believe that an extended template might be appropriate for PLND in cases of prostate cancer due to higher LN yield, increased removal of positive nodes, and fewer missed positive nodes. 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