The introduction of prostate-specific antigen (PSA) as a screening test for prostate cancer created a dramatic shift or stage migration, which led to the diagnosis of prostate cancer in earlier stages of the disease. As a result, more patients are now undergoing treatment for prostate cancer, exercising many different treatment options.

With a more frequently lower stage at the time of diagnosis has come a decrease in the need for pelvic lymphadenectomy in staging patients with prostate cancer. Nevertheless, pelvic lymphadenectomy remains an important piece of the cancer armamentarium for urologic surgeons.