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Prognostic Factors in Urologic Cancers—Assessment and Integration into Clinical Care

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

Deadline for manuscript submissions: 30 June 2024 | Viewed by 5872

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Special Issue Editors

Prof. Dr. Maximilian Burger

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Guest Editor

Department of Urology, St. Josef Medical Center, University of Regensburg, Landshuterstraße 65, 93053 Regensburg, Germany
Interests: prostate cancer; bladder cancer; renal cell cancer; uro-oncology; surgery; robotic; medical therapy; clinical management

Prof. Dr. Christian Thomas

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Guest Editor

Department of Urology, Carl Gustav Carus University Dresden, 01307 Dresden, Germany
Interests: prostate cancer; bladder cancer; renal cell cancer; uro-oncology; surgery; robotic; medical therapy; clinical management
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Special Issue Information

Dear Colleagues,

As urological oncology is constantly advancing and offering additional options for cancer care, it is becoming ever more demanding. Which therapy is the most effective for a specific condition and is especially the most effective for a specific patient in such a specific condition? Individual therapy guidance and management is required to obtain the care each patient requires; in short, personalized medicine is required. The key to such personalized medicine is the assessment and interpretation of risk factors defining the outcome of urological cancers and their integration into clinical management. Molecular markers, clinical parameters impacting surgical and medical therapy, histopathology, and socio-economic factors shape the outcome of this, but we need to understand much more. While there will be no such thing as an equation for uranological management, we should try to keep up the pace. We invite you to contribute original data, meta-analyses, and reviews which deal with prognostic factors in urological cancers to this Special Issue.

Prof. Dr. Maximilian Burger
Prof. Dr. Christian Thomas
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 short 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

prognosis
prognostic factor
clinical management
prostate cancer
bladder cancer
renal cell cancer
uro-oncology
surgery
medical therapy

Published Papers (4 papers)

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Research

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15 pages, 3054 KiB

Open AccessArticle

Assessing the Predictive Accuracy of EORTC, CUETO and EAU Risk Stratification Models for High-Grade Recurrence and Progression after Bacillus Calmette–Guérin Therapy in Non-Muscle-Invasive Bladder Cancer

by Aleksander Ślusarczyk, Karolina Garbas, Patryk Pustuła, Łukasz Zapała and Piotr Radziszewski

Cancers 2024, 16(9), 1684; https://doi.org/10.3390/cancers16091684 - 26 Apr 2024

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Abstract

The currently available EORTC, CUETO and EAU2021 risk stratifications were originally developed to predict recurrence and progression in non-muscle-invasive bladder cancer (NMIBC). However, they have not been validated to differentiate between high-grade (HG) and low-grade (LG) recurrence-free survival (RFS), which are distinct events with specific implications. We aimed to evaluate the accuracy of available risk models and identify additional risk factors for HG RFS and PFS among NMIBC patients treated with Bacillus Calmette–Guérin (BCG). We retrospectively included 171 patients who underwent transurethral resection of the bladder tumor (TURBT), of whom 73 patients (42.7%) experienced recurrence and 29 (17%) developed progression. Initially, there were 21 low-grade and 52 high-grade recurrences. EORTC2006, EORTC2016 and CUETO recurrence scoring systems lacked accuracy in the prediction of HG RFS (C-index 0.63/0.55/0.59, respectively). EAU2021 risk stratification, EORTC2006, EORTC2016, and CUETO progression scoring systems demonstrated low to moderate accuracy (C-index 0.59/0.68/0.65/0.65) in the prediction of PFS. In the multivariable analysis, T1HG at repeat TURBT (HR = 3.17 p < 0.01), tumor multiplicity (HR = 2.07 p < 0.05), previous history of HG NMIBC (HR = 2.37 p = 0.06) and EORTC2006 progression risk score (HR = 1.1 p < 0.01) were independent predictors for HG RFS. To conclude, available risk models lack accuracy in predicting HG RFS and PFS in -NMIBC patients treated with BCG. Full article

(This article belongs to the Special Issue Prognostic Factors in Urologic Cancers—Assessment and Integration into Clinical Care)

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9 pages, 824 KiB

Open AccessArticle

Feasibility of Monitoring Response to Metastatic Prostate Cancer Treatment with a Methylation-Based Circulating Tumor DNA Approach

by Thomas Büttner, Dimo Dietrich, Romina Zarbl, Niklas Klümper, Jörg Ellinger, Philipp Krausewitz and Manuel Ritter

Cancers 2024, 16(3), 482; https://doi.org/10.3390/cancers16030482 - 23 Jan 2024

Cited by 1 | Viewed by 791

Abstract

Background: Metastatic prostate cancer (mPCA) poses challenges in treatment response assessment, particularly in cases where prostate-specific antigen (PSA) levels do not reliably indicate a response. Liquid biopsy, focusing on circulating cell-free DNA (ccfDNA) methylation analysis as a proxy for circulating tumor DNA, offers a non-invasive and cost-effective approach. This study explores the potential of two methylation markers, short stature homeobox 2 (SHOX2) and Septin 9 (SEPT9), as on-mPCA-treatment biomarkers. Methods: Plasma samples were collected from 11 mPCA patients undergoing various treatments. Quantitative assessment of hypermethylated SHOX2 (mSHOX2) and SEPT9 (mSEPT9) levels in ccfDNA was conducted through methylation-specific real-time PCR. Early and overall dynamics of PSA, mSHOX2, and mSEPT9 were analyzed. Statistical evaluation employed Wilcoxon tests. Results: mSHOX2 demonstrated a significant decline post-treatment in patients with a radiographic treatment response as well as in an early treatment setting. mSEPT9 and PSA exhibited non-significant declines. In individual cases, biomarker dynamics revealed unique patterns compared to PSA. Discussion: mSHOX2 and mSEPT9 exhibit dynamics on mPCA treatment. This proof-of-concept study lays the groundwork for further investigation into these markers as valuable additions to treatment response monitoring in mPCA. Further validation in larger cohorts is essential for establishing clinical utility. Full article

(This article belongs to the Special Issue Prognostic Factors in Urologic Cancers—Assessment and Integration into Clinical Care)

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9 pages, 251 KiB

Open AccessArticle

The BETTY Score to Predict Perioperative Outcomes in Surgical Patients

by Michael Baboudjian, Rawad Abou-Zahr, Bogdan Buhas, Alae Touzani, Jean-Baptiste Beauval and Guillaume Ploussard

Cancers 2023, 15(11), 3050; https://doi.org/10.3390/cancers15113050 - 04 Jun 2023

Cited by 2 | Viewed by 884

Abstract

The aim of this study is to evaluate a new user-friendly scoring system, namely the BETTY score, that aims to predict 30-day patient outcomes after surgery. In this first description, we rely on a population of prostate cancer patients undergoing robot-assisted radical prostatectomy. The BETTY score includes the patient’s American Society of Anesthesiologists score, the body mass index, and intraoperative data, including operative time, estimated blood loss, any major intraoperative complications, hemodynamic, and/or respiratory instability. There is an inverse relationship between the score and severity. Three clusters assessing the risk of postoperative events were defined: low, intermediate, and high risk of postoperative events. A total of 297 patients was included. The median length of hospital stay was 1 day (IQR1-2). Unplanned visits, readmissions, any complications, and serious complications occurred in 17.2%, 11.8%, 28.3%, and 5% of cases, respectively. We found a statistically significant correlation between the BETTY score and all endpoints analyzed (all p ≤ 0.01). A total of 275, 20, and 2 patients were classified as low-, intermediate-, and high-risk according to the BETTY scoring system, respectively. Compared with low-risk patients, patients at intermediate-risk were associated with worse outcomes for all endpoints analyzed (all p ≤ 0.04). Future studies, in various surgical subspecialties, are ongoing to confirm the usefulness of this easy-to-use score in routine. Full article

(This article belongs to the Special Issue Prognostic Factors in Urologic Cancers—Assessment and Integration into Clinical Care)

Review

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13 pages, 727 KiB

Open AccessReview

Prognostic Factors and Current Treatment Strategies for Renal Cell Carcinoma Metastatic to the Brain: An Overview

by Valeria Internò, Pierluigi De Santis, Luigia Stefania Stucci, Roberta Rudà, Marco Tucci, Riccardo Soffietti and Camillo Porta

Cancers 2021, 13(9), 2114; https://doi.org/10.3390/cancers13092114 - 27 Apr 2021

Cited by 12 | Viewed by 3488

Abstract

Renal cell carcinoma (RCC) is one of primary cancers that frequently metastasize to the brain. Brain metastasis derived from RCC has the propensity of intratumoral hemorrhage and relatively massive surrounding edema. Moreover, it confers a grim prognosis in a great percentage of cases with a median overall survical (mOS) around 10 months. The well-recognized prognostic factors for brain metastatic renal cell carcinoma (BMRCC) are Karnofsky Performance Status (KPS), the number of brain metastasis (BM), the presence of a sarcomatoid component and the presence of extracranial metastasis. Therapeutic strategies are multimodal and include surgical resection, radiotherapy, such as stereotactic radiosurgery due to the radioresistance of RCC and systemic strategies with tyrosin kinase inhibitors (TKI) or Immune checkpoint inhibitors (ICI) whose efficacy is not well-established in this setting of patients due to their exclusion from most clinical trials. To date, in case of positive prognostic factors and after performing local radical therapies, such as complete resection of BM or stereotactic radiosurgery (SRS), the outcome of these patients significantly improves, up to 33 months in some patients. As a consequence, tailored clinical trials designed for BMRCC are needed to define the correct treatment strategy even in this poor prognostic subgroup of patients. Full article

(This article belongs to the Special Issue Prognostic Factors in Urologic Cancers—Assessment and Integration into Clinical Care)

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