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New Trends in Urologic Oncology: Surgical Treatments, Robotics, Biomarkers, Diagnostic Tools, and Innovative Therapies

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

Deadline for manuscript submissions: 31 July 2026 | Viewed by 4391

Special Issue Editors

Dr. Alessandro Uleri

E-Mail Website
Guest Editor
Department of Urology, UROSUD, La Croix du Sud Hospital, Quint Fonsegrives, France
Interests: prostate cancer; BPH; urothelial cancer
Dr. Roberto Contieri

E-Mail Website
Guest Editor
Department of Urology, Istituto Nazionale Tumori “Fondazione Pascale”, 80131 Naples, Italy
Interests: bladder cancer; urothelial carcinoma; non-muscle-invasive bladder cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Urologic oncology is undergoing rapid development, with significant progress across surgical, diagnostic, and therapeutic domains. This Special Issue, “New Trends in Urologic Oncology: Surgical Treatments, Robotics, Biomarkers, Diagnostic Tools, and Innovative Therapies”, will provide an overview of the most recent advances shaping the management of genitourinary malignancies. Particular attention will be given to the evolution of minimally invasive and robotic-assisted techniques, the refinement of surgical outcomes, and the integration of novel systemic and targeted treatment strategies.

In parallel, the identification and clinical implementation of biomarkers, together with advances in molecular and imaging-based diagnostics, are enabling earlier detection, more precise risk stratification, and individualized therapeutic approaches. These developments are progressively moving the field toward a model of precision oncology, in which treatment decisions are informed by both technological innovation and molecular characterization.

We welcome contributions in the form of original research articles, reviews, and clinical studies that reflect these advances and will help in defining new standards of care.

Dr. Alessandro Uleri
Dr. Roberto Contieri
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 250 words) can be sent to the Editorial Office for assessment.

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
  • renal cancer
  • bladder cancer
  • UTUC
  • testicular cancer
  • penile cancer
  • biomarkers

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Published Papers (4 papers)

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Research

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15 pages, 1519 KB  
Article
Surgical Margin Status and Minimal Margin Width in Penile Squamous Cell Carcinoma: Local Recurrence and Survival Outcomes in a Single-Centre Cohort
by Mateusz Czajkowski, Michał Falis, Jan Mandrysz, Magdalena Sternau, Marcin Matuszewski and Oliver W. Hakenberg
Cancers 2026, 18(10), 1535; https://doi.org/10.3390/cancers18101535 - 9 May 2026
Viewed by 492
Abstract
Background/Objectives: Optimal surgical margin management in penile squamous cell carcinoma remains debated because organ-preserving surgery must balance oncological control with functional preservation. Historically, wide excision margins have been recommended; however, subsequent evidence has challenged this threshold, shifting practice towards narrower margins without [...] Read more.
Background/Objectives: Optimal surgical margin management in penile squamous cell carcinoma remains debated because organ-preserving surgery must balance oncological control with functional preservation. Historically, wide excision margins have been recommended; however, subsequent evidence has challenged this threshold, shifting practice towards narrower margins without a demonstrated increase in local recurrence. We evaluated whether invasive positive surgical margins and minimal negative margin widths were associated with local recurrence and survival after surgery for penile squamous cell carcinoma. Methods: We retrospectively analysed 157 consecutive men who underwent surgical treatment at a single centre between 2011 and 2024. Time-to-event analyses were performed in 131 patients with invasive non-metastatic disease after excluding those with penile intraepithelial neoplasia (PeIN)-only lesions (n = 23) and distant metastases (n = 3) at diagnosis. The margins were classified as either invasive-negative or invasive-positive. Among histologically negative-margin cases, minimal margin width was grouped a priori as <2 mm, 2–5 mm, and >5 mm. Results: The median follow-up was 25 months (interquartile range [IQR], 10–52). In the invasive (M0) cohort, 101/131 patients had invasive-negative margins and 30/131 had invasive-positive margins; local recurrence occurred in 42/131 patients. Margin status was not independently associated with recurrence-free, overall, or cancer-specific survival rates. Non-sparing surgery was associated with a lower hazard of local recurrence, whereas grade 3 (G3) histology independently predicted worse recurrence-free, overall, and cancer-specific survival. Advanced stage according to the Tumour, Node, Metastasis (TNM) classification independently predicted worse cancer-specific survival. Conclusions: Among patients with histologically negative margins, outcomes did not differ significantly across the predefined margin-width categories. These findings support tissue-preserving surgery aimed at histologically negative margins within a structured surveillance framework. Full article
(This article belongs to the Special Issue New Trends in Urologic Oncology: Surgical Treatments, Robotics, Biomarkers, Diagnostic Tools, and Innovative Therapies)
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19 pages, 1439 KB  
Article
Neoadjuvant Intravesical Mitomycin C for NMIBC: A Phase III Single-Center, Open-Label Randomized Clinical Trial
by Roberto Contieri, Alberto Saita, Marco Paciotti, Alessandro Uleri, Pier Paolo Avolio, Vittorio Fasulo, Ludovica Cella, Stefano Mancon, Federica Sordelli, Alessio Finocchiaro, Giuseppe Garofano, Paola Arena, Chiara Pozzi, Andrea Gatti, Michela Lizier, Miriam Cieri, Piergiuseppe Colombo, Nicolò Maria Buffi, Giovanni Lughezzani, Paolo Casale, Massimo Lazzeri and Rodolfo Hurleadd Show full author list remove Hide full author list
Cancers 2026, 18(9), 1444; https://doi.org/10.3390/cancers18091444 - 30 Apr 2026
Viewed by 451
Abstract
Background and Objective: Transurethral resection of bladder tumor (TURBT) is the standard for non-muscle-invasive bladder cancer (NMIBC), yet recurrence rates remain high. This study evaluates the safety, tolerability, and efficacy of neoadjuvant intravesical mitomycin C (neoMMC) before TURBT in reducing recurrence and improving [...] Read more.
Background and Objective: Transurethral resection of bladder tumor (TURBT) is the standard for non-muscle-invasive bladder cancer (NMIBC), yet recurrence rates remain high. This study evaluates the safety, tolerability, and efficacy of neoadjuvant intravesical mitomycin C (neoMMC) before TURBT in reducing recurrence and improving surgical outcomes. Methods: This randomized phase III trial enrolled patients with primary or recurrent NMIBC. Participants were randomized 1:1 to a neoadjuvant group receiving two instillations of MMC (day −14 and −7) before TURBT, or a control group undergoing standard TURBT without neoadjuvant treatment. The primary endpoint was 12-month recurrence-free survival (RFS). Secondary endpoints included surgical quality (complete resection, cauterization only, absence of residual tumor) and safety. Exploratory endpoints included histopathologic response and time to recurrence. Key Findings and Limitations: Among 95 patients (48 neoMMC, 47 controls), baseline characteristics were balanced. After a median follow-up of 19.4 months, recurrences occurred in 9 StA and 4 NeoA patients, with one progression to MIBC in the NeoA arm. RFS did not differ significantly between groups at 12 or 18 months. Neoadjuvant MMC was well tolerated, with only grade 1–2 AEs. Exploratory microbiota analyses suggested that neoadjuvant MMC modulated urinary microbial diversity and was associated with a microbiota profile more similar to that observed in non-recurrent patients. Limitations include single-center design and relatively short follow-up. Conclusions and Clinical Implications: Neoadjuvant intravesical MMC before TURBT was feasible and well tolerated in patients with NMIBC, with no unexpected safety signals. In this prematurely terminated and underpowered trial, no significant improvement in RFS was observed. Larger adequately powered studies are needed to clarify the oncologic efficacy of this approach. Full article
(This article belongs to the Special Issue New Trends in Urologic Oncology: Surgical Treatments, Robotics, Biomarkers, Diagnostic Tools, and Innovative Therapies)
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10 pages, 246 KB  
Article
Transition from Transrectal Systematic to Transperineal Lesion-Focused Prostate Biopsy: A Real-World Comparative Analysis
by Thibaut Long Depaquit, Federica Sordelli, Christopher Agüero, Arthur Peyrottes, Alessandro Uleri, Laurent Daniel, David Chemouni, Cyrille Bastide and Michael Baboudjian
Cancers 2026, 18(2), 332; https://doi.org/10.3390/cancers18020332 - 21 Jan 2026
Viewed by 534
Abstract
Background/Objectives: The transperineal (TP) approach has progressively replaced the transrectal (TR) approach for prostate biopsy because of its improved safety profile. However, its impact on the detection of clinically significant prostate cancer (csPCa), particularly within modern lesion-focused biopsy strategies that combine targeted and [...] Read more.
Background/Objectives: The transperineal (TP) approach has progressively replaced the transrectal (TR) approach for prostate biopsy because of its improved safety profile. However, its impact on the detection of clinically significant prostate cancer (csPCa), particularly within modern lesion-focused biopsy strategies that combine targeted and perilesional sampling, remains uncertain. We aimed to evaluate the real-world diagnostic impact of transitioning from a TR systematic-based biopsy strategy to a TP lesion-focused approach. Methods: We conducted a retrospective single-centre study including consecutive men who underwent image-guided prostate biopsy between 2018 and 2025. Only patients with a single MRI-visible lesion (PI-RADS ≥ 3) were included. Two biopsy strategies were compared: TR systematic biopsy (TR–SBx), combining targeted and systematic cores, and TP lesion-focused biopsy (TP–LFx), combining targeted and perilesional cores. The primary outcome was the detection of csPCa (Gleason Grade Group ≥ 2). Secondary outcomes included detection of Gleason Grade Group 1 cancer and negative biopsies. Inverse probability of treatment weighting (IPTW) based on a propensity score was applied to adjust for baseline differences. Doubly robust weighted logistic regression models were used, with predefined subgroup and sensitivity analyses. Results: Among 1032 included patients, 931 underwent TR–SBx and 101 TP–LFx. After restriction to the region of common support, 528 patients were retained for IPTW analyses. In the IPTW-adjusted analysis, TP–LFx was associated with higher csPCa detection compared with TR–SBx (adjusted odds ratio [OR] 2.52, 95% confidence interval [CI] 1.40–4.52; p = 0.002) and with lower detection of Gleason Grade Group 1 cancer (OR 0.50, 95% CI 0.27–0.92; p = 0.03). Subgroup analyses suggested a stronger association in patients with prior negative biopsy and in anterior or apical lesions. Conclusions: In routine clinical practice, transitioning from a transrectal systematic-based biopsy strategy to a transperineal lesion-focused approach was associated with improved detection of csPCa and reduced overdiagnosis. These findings support the consideration of transperineal, lesion-focused MRI-guided biopsy strategies in contemporary prostate cancer diagnostics. Full article
(This article belongs to the Special Issue New Trends in Urologic Oncology: Surgical Treatments, Robotics, Biomarkers, Diagnostic Tools, and Innovative Therapies)

Review

Jump to: Research

13 pages, 281 KB  
Review
Therapeutic Intensification Based on Immune Checkpoint Inhibitors in Non-Muscle Invasive Bladder Cancer: State of the Art and Future Perspectives
by Pierre-Etienne Gabriel, Amir Horowitz, Felix Guerrero-Ramos, Francesco Soria, Marco Moschini, David D’Andrea, Benjamin Pradère, John P. Sfakianos and Evanguelos Xylinas
Cancers 2025, 17(21), 3555; https://doi.org/10.3390/cancers17213555 - 2 Nov 2025
Viewed by 2397
Abstract
Background/Objectives: Systemic immunotherapy, previously used mainly for advanced urothelial carcinoma, now plays an important role in the treatment of non-muscle invasive bladder cancer (NMIBC), either alone or combined with intravesical BCG instillations. Methods: We conducted a collaborative, comprehensive review to summarize the key [...] Read more.
Background/Objectives: Systemic immunotherapy, previously used mainly for advanced urothelial carcinoma, now plays an important role in the treatment of non-muscle invasive bladder cancer (NMIBC), either alone or combined with intravesical BCG instillations. Methods: We conducted a collaborative, comprehensive review to summarize the key evidence and future perspectives on therapeutic intensification strategies involving immune checkpoint inhibitors in NMIBC. A total of 51 references published between 2000 and 2025 were included. Results: Four phase II studies evaluated pembrolizumab, atezolizumab, durvalumab, and cetrelimab as monotherapy in 28 to 132 BCG-unresponsive NMIBC patients. They reported complete response rates ranging from 12% to 43% after 3 to 12 months of treatment, with a durable response rate ranging from 49% to 57.4% at 12 months. To improve these results, a phase II trial launched this year tests a new systemic combination targeting both the PD-1/PD-L1 axis and the emerging HLA-E/NKG2A pathway. Regarding BCG-naïve high-risk (HR) NMIBC, four phase III studies are evaluating BCG instillations combined with systemic immunotherapy: sasanlimab (CREST), durvalumab (POTOMAC), atezolizumab (ALBAN), and pembrolizumab (KEYNOTE-676), with significant results reported for the CREST and POTOMAC trials. The key challenge remains selecting patients most likely to benefit from this combination therapy while avoiding overtreatment. Identifying predictive biomarkers of tumor aggressiveness and response to immunotherapy also represents a major future challenge. Conclusions: Therapeutic intensification using systemic immunotherapy applies to both BCG-unresponsive NMIBC, with a new target pathway (HLA-E/NKG2A), and BCG-naïve HR NMIBC, where the combination of BCG instillations and immunotherapy represents a major breakthrough. Full article
(This article belongs to the Special Issue New Trends in Urologic Oncology: Surgical Treatments, Robotics, Biomarkers, Diagnostic Tools, and Innovative Therapies)
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