Urothelial Carcinoma: Role of Biomarkers in Diagnosis, Prognosis and Treatment (2nd Edition)

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 2744

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Guest Editor
Department of Urology, University Hospital of Larisa, University of Thessaly, 41335 Larisa, Greece
Interests: laparoscopic surgery; urology; robotic surgery; urogenital cancer
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Guest Editor
1. Department of Medical Oncology, IASO Thessalias Hospital, Larissa, Greece
2. Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
Interests: identification of biomarkers for prostate; kidney and bladder cancer; neuroendocrine prostate cancer; PSMA theranostics; upper tract urothelial carcinoma; treatment-resistant urothelial carcinoma; genomics and immunogenomics for urological cancers
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Special Issue Information

Dear Colleagues,

The second most frequently diagnosed urological tumor worldwide is urothelial carcinoma (UC), which involves the bladder and upper urinary tract. Approximately 70–75% of the cases are non-invasive or low grade. Urine cytology and cystoscopy are the basic methods for the investigation of hematuria. If abnormal tissue is cystoscopically found, then a transurethral biopsy is recommended. Although cystoscopy is the gold standard for the diagnosis of UCs, there are two disadvantages: it is invasive and costly. On the other hand, cytology is less sensitive for low-grade tumors. The success of treatment is correlated with the detection of UCs in the early stages. Moreover, recurrence and progression dominate the natural history of UC. Hence, there has been a lot of research in order to identify biological markers for the diagnosis of UC in order to fill the gap of cystoscopy and urine cytology, therefore leading to the era of precision medicine. Many biomarkers have been studied in different clinical situations such as prognosis, diagnosis and treatment. However, there are some drawbacks in finding the appropriate biomarkers that are validated and utilized in clinical practice. First, the detection of a reliable marker is difficult due to a lack of accuracy. Secondly, the process of validation is too complex to be introduced into daily clinical practice, and finally, they must be evaluated into preclinical as well as prospective studies in larger cohorts. Therefore, the current American Urological Association (AUA) and European Association of Urology (EAU) guidelines draw attention against the use of biomarkers instead of cystoscopy and urine cytology. Clearly, it is of great interest to identify new potential biomarkers which will facilitate the management of patients suffering from UC, meaning that these markers will allow for a reliable and timely diagnosis, treatment and prognosis.

Dr. Ioannis Zachos
Dr. Panagiotis Vlachostergios
Guest Editors

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Keywords

  • urothelial carcinoma
  • biomarker
  • diagnosis
  • treatment
  • prognosis

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Published Papers (2 papers)

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Research

14 pages, 605 KB  
Article
Factors Affecting Oncological Outcomes in Upper Tract Urothelial Carcinoma Patients with Chronic Kidney Disease and End-Stage Renal Disease
by Hung-Keng Li, Hsiang-Ying Lee, Hsin-Chih Yeh, Chao-Yuan Huang, Chung-Hsin Chen, Chao-Hsiang Chang, Chin-Chung Yeh, Han-Yu Weng, Ta-Yao Tai, Yao-Chou Tsai, Shu-Yu Wu, Yuan-Hong Jiang, Yu-Khun Lee, I-Hsuan Alan Chen, Jen-Tai Lin, Thomas Y. Hsueh, Bing-Juin Chiang, Yung-Tai Chen, Jen-Shu Tseng, Chia-Chang Wu, Ting-En Tai, Wei-Yu Lin and Shiu-Dong Chungadd Show full author list remove Hide full author list
Biomedicines 2026, 14(3), 554; https://doi.org/10.3390/biomedicines14030554 - 28 Feb 2026
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Abstract
Background/Objectives: We assessed factors affecting the oncological outcomes in upper tract urothelial carcinoma patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) in Taiwan, using a large domestic upper tract urothelial carcinoma collaboration database. Methods: From July 1988 to [...] Read more.
Background/Objectives: We assessed factors affecting the oncological outcomes in upper tract urothelial carcinoma patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) in Taiwan, using a large domestic upper tract urothelial carcinoma collaboration database. Methods: From July 1988 to December 2019, 15 hospitals joined the Taiwan Upper Tract Urothelial Carcinoma Collaboration Group. A total of 690 patients were included, and demographic, clinical, and pathological data were compared. Factors related to overall survival, cancer-specific survival, disease-free survival, and bladder recurrence-free survival were analyzed. Results: Out of the 690 patients, 605 had CKD and 85 had ESRD. In multivariate analysis, overall survival was associated with CKD stage (p = 0.024), age > 70 years (p = 0.002), and pathological stage III/IV (p = 0.014 and <0.001). Cancer-specific survival was associated with middle ureter tumors (p = 0.041), positive surgical margin (p = 0.005), and pathological stage III/IV (p = 0.010 and <0.001). Disease-free survival was associated with middle ureter tumors (p = 0.001), lower ureter tumors (p = 0.010), and pathological stage III/IV (p = 0.039 and <0.001). Female sex (p = 0.027), lower ureter tumors (p = 0.027), coronary artery disease (p = 0.047), and arrhythmias (p = 0.044) were associated with bladder recurrence-free survival. Conclusions: The oncological outcomes of UTUC patients with CKD and ESRD in Taiwan were affected by various factors. Tumor location and advanced pathological stage were related to OS, CSS, and DFS. Cardiac diseases were possibly related to BRFS. Full article
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18 pages, 5758 KB  
Article
Integrated Proteogenomic Approach for Discovering Potential Biomarkers in Urothelial Carcinoma of the Bladder
by Pongsakorn Choochuen, Surasak Sangkhathat, Wararat Chiangjong, Worapat Attawettayanon, Kittinun Leetanaporn, Komwit Surachat, Panupong Sukpan, Wararak Kaewrattana, Ornsinee Senkhum, Natthapon Khongcharoen, Natakorn Nokchan, Nifahmee Hayiniloh, Dussadee Nuktong, Pasu Tansakul, Kant Buaban, Anas Binkasem and Virote Chalieopanyarwong
Biomedicines 2025, 13(12), 3020; https://doi.org/10.3390/biomedicines13123020 - 10 Dec 2025
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Abstract
Background/Objectives: Urothelial carcinoma of the bladder (UCC) is a leading cause of cancer-related death globally. Given that urine is in direct contact with the tumor, it represents a highly valuable source for non-invasive molecular analysis. Methods: This study utilized liquid biopsies [...] Read more.
Background/Objectives: Urothelial carcinoma of the bladder (UCC) is a leading cause of cancer-related death globally. Given that urine is in direct contact with the tumor, it represents a highly valuable source for non-invasive molecular analysis. Methods: This study utilized liquid biopsies from 41 UCC patients and 27 non-cancerous hematuria controls to identify novel diagnostic and prognostic biomarkers via proteomic and transcriptomic analysis. Results: Urine proved to be a reliable source, yielding a mean tumor cell fraction of 0.605 (95% CI: 0.505–0.705). We identified 11 genes with concurrent alteration at both the urinary protein and mRNA levels. Notably, four upregulated markers, CYTB, C1QC, SBP1, and ANXA4, demonstrated strong diagnostic potential, with AUC values greater than 0.70. CYTB and ANXA4 were detectable even in early-stage UCC (stages Cis, I, and II). Furthermore, we identified two proteins, CATC and SPB10, that were markedly upregulated in recurrent UCC and correlated with poor overall survival, positioning them as potential prognostic markers for recurrence risk. Conclusions: This study confirms the utility of urine as a reliable medium for detecting UCC tumor cells, offering promising markers for both early-stage diagnosis and predicting NMIBC recurrence. Full article
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