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BACKGROUND Pelvic lymph node dissection (PLND) represents the gold standard of lymph node staging in prostate cancer (PCa) patients. OBJECTIVE To assess the effect of extended PLND on oncologic outcomes in PCa patients with D'Amico intermediate- or high-risk characteristics treated with radical prostatectomy (RP). PATIENTS AND METHODS 9,742 patients who underwent RP (2000-2017) with or without PLND were identified from a multi-institutional database of four centers. Only patients with a probability >5% for lymph node invasion according to the Briganti nomogram were included. 2:1 propensity score matching was performed to account for potential differences between the two cohorts. Cox regression models tested the effect of PLND on biochemical recurrence (BCR), metastasis and cancer-specific mortality (CSM). RESULTS Overall, 707 (7.3%) patients did not undergo PLND. Of those, 520 and 187 harbored D'Amico intermediate- and high- risk characteristics, respectively. Median number of removed lymph nodes was 14 (interquartile range:8-21) in the PLND cohort; 19.0% (n=1,714) of those harbored lymph node metastases. After propensity score matching, BCR-, metastasis- and CSM-free survival rates were 60.4 vs. 65.6% (p=0.07), 87.0 vs. 90.0% (p=0.06) and 95.2 vs. 96.4% (p=0.2) at 120 months after RP for PLND and no PLND, respectively. Multivariable Cox regression models adjusted for postoperative and preoperative tumor characteristics revealed that PLND performed at RP is no independent predictor for BCR, metastasis or CSM (all:p≥0.1). CONCLUSION There was no significant difference in oncologic outcomes for patients with D'Amico high- or intermediate-risk PCa with or without PLND performed at RP. The therapeutic value of PLND remains unclear.