Prostate Cancer: Contemporary Standards and Challenges

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 23 October 2025 | Viewed by 794

Special Issue Editors


E-Mail Website
Guest Editor
Moffitt Cancer Center, Tampa, FL, USA
Interests: risk-adapted therapy in prostate cancer; management of oligometastatic cancer; treatment de-escalation in prostate cancer; precision medicine; chemotherapy; hormonal therapy

E-Mail Website
Guest Editor
Moffitt Cancer Center, Tampa, FL, USA
Interests: prostate cancer; overcoming therapeutic resistance using evolutionary biology and game theoretical concepts; risk-adapted therapy in prostate cancer; treatment de-escalation in prostate cancer; precision medicine; chemotherapy; hormonal therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As the second most common cancer among men worldwide, prostate cancer is a major public health concern, and its incidence is rising. In recent decades, researchers have made substantial progress in the molecular characterization, diagnosis, and treatment of this disease, which have greatly improved the outcomes of men with prostate cancer. Breakthroughs in theranostics leveraging the highly prevalent expression of the prostate-specific membrane antigen and improved genetic understanding of the role defects in the homologous recombination pathway play in carcinogenesis have paved the way for truly personalized management.

Recent attempts at intensifying treatment using multiagent combinations have significantly prolonged survival for many patients. However, recognizing the wide variability in clinical behavior of prostate cancer, concerns remain about overtreating some with more indolent, hormone-responsive disease.

Ongoing trials tackle questions surrounding adequate risk stratification, and many have built-in escalation or de-escalation strategies to balance the efficacy and toxicity burden of novel treatments. In this Special Issue, we aim to provide a comprehensive, multidisciplinary, and contemporary perspective on current standards and challenges in the management of prostate cancer.

To this end, we welcome original research, as well as comprehensive reviews and opinion pieces from experts and researchers in the field.

Dr. Filip Ionescu
Dr. Jingsong Zhang
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostate cancer
  • molecular pathogenesis
  • precision oncology
  • biomarkers
  • treatment de-escalation

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (1 paper)

Order results
Result details
Select all
Export citation of selected articles as:

Research

28 pages, 3251 KB  
Article
Predictors of ISUP Grade Group Discrepancies Between Biopsy and Radical Prostatectomy: A Single-Center Analysis of Clinical, Imaging, and Histopathological Parameters
by Victor Pasecinic, Dorin Novacescu, Flavia Zara, Cristina-Stefania Dumitru, Vlad Dema, Silviu Latcu, Razvan Bardan, Alin Adrian Cumpanas, Raluca Dumache, Talida Georgiana Cut, Hossam Ismail and Ademir Horia Stana
Cancers 2025, 17(15), 2595; https://doi.org/10.3390/cancers17152595 - 7 Aug 2025
Viewed by 418
Abstract
Background/Objectives: ISUP grade group discordance between prostate biopsy and radical prostatectomy (RP) impacts treatment decisions in over a third (~25–40%) of prostate cancer (PCa) patients. We aimed to identify ISUP grade migration predictors and assess the impact of preoperative imaging (MRI) in [...] Read more.
Background/Objectives: ISUP grade group discordance between prostate biopsy and radical prostatectomy (RP) impacts treatment decisions in over a third (~25–40%) of prostate cancer (PCa) patients. We aimed to identify ISUP grade migration predictors and assess the impact of preoperative imaging (MRI) in a contemporary Romanian PCa cohort. Methods: We retrospectively analyzed 142 PCa patients undergoing RP following biopsy between January 2021 and December 2024 at Pius Brinzeu County Hospital, Timișoara: 90 without and 52 with preoperative MRI. Clinical parameters, MRI findings (PI-RADS), and biopsy characteristics were evaluated. Machine learning models (gradient boosting, random forest) were developed with SHAP analysis for interpretability. Results: Grade migration occurred in 69/142 patients (48.6%): upstaging in 55 (38.7%) and downstaging in 14 (9.9%). In the non-MRI cohort, 37/90 (41.1%) were upstaged and 9/90 (10.0%) were downstaged, versus 18/52 (34.6%) upstaged and 5/52 (9.6%) downstaged in the MRI cohort. The MRI group showed a 6.5% absolute reduction in upstaging (34.6% vs. 41.1%), a promising non-significant trend (p = 0.469) that requires further investigation. Grade 1 patients showed the highest upstaging (69.4%), while Grades 3–4 showed the highest downstaging (11/43, 25.6%). PI-RADS 4 lesions had the highest upstaging (43.5%). PSA density > 0.20 ng/mL2 emerged as the strongest predictor. Gradient boosting achieved superior performance (AUC = 0.812) versus logistic regression (AUC = 0.721), representing a 13% improvement in discrimination. SHAP analysis revealed PSA density as the most influential (importance: 0.287). Grade migration associated with adverse pathology: extracapsular extension (52.7% vs. 28.7%, p = 0.008) and positive margins (38.2% vs. 21.8%, p = 0.045). Conclusions: ISUP grade migration affects 48.6% of Romanian patients, with 38.7% upstaged and 9.9% downstaged. The 69.4% upstaging in Grade 1 patients emphasizes the need for enhanced risk stratification tools, while 10% downstaging suggests potential overtreatment. Machine learning with SHAP analysis provides superior predictive performance (13% AUC improvement) while offering clinically interpretable risk assessments. PSA density dominates risk assessment, while PI-RADS 4 lesions warrant closer scrutiny than previously recognized. Full article
(This article belongs to the Special Issue Prostate Cancer: Contemporary Standards and Challenges)
Show Figures

Figure 1

Back to TopTop