The MSKCC PLND RCT | Please explain!!!

What are we to make of this large RCT of extended vs standard pelvic lymph node dissection (PLND) for prostate cancer?? Despite it not meeting its primary endpoint of improving biochemical recurrence, the authors now report in European Urology that it does reduce the incidence of distant metastases 10 years later! Go figure! We chat with Dr Karim Touijer (MSKCC) and try to figure it out. We ask about data dredging, p-hacking and statistical shenanigans, and how adding two minutes and two extra lymph nodes to a PLND could possibly lead to reduced metastases. Plus guest comments from Dr John Yaxley (Brisbane). What do you think??!! Will this change practice?? Will this change guidelines? Tune in and share your thoughts!Even better on our YouTube channelLinks:Paper in European Urology Previous GU Cast with Karim discussing earlier paper (Feb 2022)