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Cancers
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Urogenital Neoplasms Pathology
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Urogenital Neoplasms Pathology

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

Deadline for manuscript submissions: 30 September 2025 | Viewed by 5952

Special Issue Editor

Dr. Carlo Introini

E-Mail Website
Guest Editor
Unit of Urology, Department of Abdominal Surgery, Galliera Hospital, 16128 Genoa, Italy
Interests: radical cystectomy; radical prostatectomy; renal surgery; laparoscopy; robotic surgery

Special Issue Information

Dear Colleagues,

Uro-oncological diseases affect a large population of middle and advanced age in both sexes. The anatomical extension of the urinary tract determines diagnostic difficulties that require ever more innovative technology. Small-caliber fiber-optic instruments and high-definition vision systems increase diagnostic accuracy. Equally, the histopathological, molecular and genetic methods of investigation allow the resolution of the differential diagnosis. The treatment of urological neoplasms relies on more comfortable techniques for the patient, such as laparoscopy and robotic surgery, which make it possible to obtain a high standard of care and functional preservation by reducing the hospitalization time. Robotic surgery, in particular, finds application in all intra-abdominal urological neoplasms, and for this reason it has expanded all over the world. Urologists who have extensive experience in these areas are invited to contribute their experiences, projects and achievements to this Special Issue.

Dr. Carlo Introini
Guest Editor

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

  • urethroscopy
  • bladder cancer
  • prostate cancer
  • renal cancer
  • robotic surgery
  • laparoscopy
  • prostate biopsy

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Published Papers (4 papers)

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Research

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9 pages, 680 KiB  
Article
The Role of Bladder-Washing Cytology as an Adjunctive Method to Cystoscopy During Follow-Up for Low-Grade TaT1 Non-Muscle-Invasive Bladder Cancer
by Enric Carbonell, Clàudia Mercader, Héctor Alfambra, Paulette Narvaez, Eric Villalba, Rita Pagès, Ignacio Asiain, Meritxell Costa, Agustín Franco, Antonio Alcaraz, María José Ribal and Antoni Vilaseca
Cancers 2024, 16(21), 3708; https://doi.org/10.3390/cancers16213708 - 1 Nov 2024
Viewed by 1084
Abstract
Background and Objective: The role of urine cytology during follow-up for low-grade (LG) non-muscle-invasive bladder cancer (NMIBC) is not well established, although cytology has low sensitivity in detecting LG recurrences. Our study aims to evaluate the impact of urine cytology as a complementary [...] Read more.
Background and Objective: The role of urine cytology during follow-up for low-grade (LG) non-muscle-invasive bladder cancer (NMIBC) is not well established, although cytology has low sensitivity in detecting LG recurrences. Our study aims to evaluate the impact of urine cytology as a complementary method to cystoscopy during follow-up for LG NMIBC. Methods: Patients diagnosed with primary LG TaT1 bladder cancer (BC) between 2010 and 2020 were included. Patients were stratified according to the EAU NMIBC scoring model. Urine cytology was performed during follow-up cystoscopy. The outcomes of the study were BC recurrence and upgrading to high-grade (HG). Cytology utility was established by assessing whether its result led to management change. Results: We included 337 patients with LG TaT1 BC. EAU risk group distribution was low in 262 (77.7%), intermediate in 57 (16.9%), and high-risk in 18 (5.3%) cases. With a median follow-up of 5 years, 166 (49.3%) patients experienced recurrence. Cystoscopy was positive in 154 (92.8%) and suspicious in 12 (7.2%) cases. Urine cytology was positive in 33 (19.9%) cases but only changed management in 3 (0.89%), all with suspicious cystoscopy. Positive cytology at first recurrence was associated with higher risk of upgrading during follow-up (HR 2.781, p = 0.006) and lower upgrading-free survival (p = 0.001). Conclusions: The role of urine cytology to detect first recurrences during follow-up for primary LG TaT1 NMIBC might be limited to patients with non-conclusive lesions in the cystoscopy. A positive cytology at first recurrence is associated with a higher risk of upgrading to HG BC during follow-up. Full article
(This article belongs to the Special Issue Urogenital Neoplasms Pathology)
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9 pages, 257 KiB  
Article
Quantification of Gleason Pattern 4 at MRI-Guided Biopsy to Predict Adverse Pathology at Radical Prostatectomy in Intermediate-Risk Prostate Cancer Patients
by Hubert Kamecki, Łukasz Mielczarek, Stanisław Szempliński, Małgorzata Dębowska, Paweł Rajwa, Michael Baboudjian, Jakob Klemm, Juan Gómez Rivas, Elza Modzelewska, Omar Tayara, Wojciech Malewski, Przemysław Szostek, Sławomir Poletajew, Piotr Kryst, Roman Sosnowski and Łukasz Nyk
Cancers 2023, 15(22), 5462; https://doi.org/10.3390/cancers15225462 - 17 Nov 2023
Cited by 2 | Viewed by 1530
Abstract
Background: Data on Gleason pattern 4 (GP4) amount in biopsy tissue is important for prostate cancer (PC) risk assessment. We aim to investigate which GP4 quantification method predicts adverse pathology (AP) at radical prostatectomy (RP) the best in men diagnosed with intermediate-risk (IR) [...] Read more.
Background: Data on Gleason pattern 4 (GP4) amount in biopsy tissue is important for prostate cancer (PC) risk assessment. We aim to investigate which GP4 quantification method predicts adverse pathology (AP) at radical prostatectomy (RP) the best in men diagnosed with intermediate-risk (IR) PC at magnetic resonance imaging (MRI)-guided biopsy. Methods: We retrospectively included 123 patients diagnosed with IR PC (prostate-specific antigen <20 ng/mL, grade group (GG) 2 or 3, no iT3 on MRI) at MRI-guided biopsy, who underwent RP. Twelve GP4 amount-related parameters were developed, based on GP4 quantification method (absolute, relative to core, or cancer length) and site (overall, targeted, systematic biopsy, or worst specimen). Additionally, we calculated PV×GP4 (prostate volume × GP4 relative to core length in overall biopsy), aiming to represent the total GP4 volume in the prostate. The associations of GP4 with AP (GG ≥ 4, ≥pT3a, or pN1) were investigated. Results: AP was reported in 39 (31.7%) of patients. GP4 relative to cancer length was not associated with AP. Of the 12 parameters, the highest ROC AUC value was seen for GP4 relative to core length in overall biopsy (0.65). an even higher AUC value was noted for PV × GP4 (0.67), with a negative predictive value of 82.8% at the optimal threshold. Conclusions: The lack of an association of GP4 relative to cancer length with AP, contrasted with the better performance of other parameters, indicates directions for future research on PC risk stratification to accurately identify patients who may not require immediate treatment. Incorporating formulas aimed at GP4 volume assessment may lead to obtaining models with the best discrimination ability. Full article
(This article belongs to the Special Issue Urogenital Neoplasms Pathology)

Review

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14 pages, 999 KiB  
Review
Sexual-Sparing Radical Cystectomy in the Robot-Assisted Era: A Review on Functional and Oncological Outcomes
by Carlo Introini, Manfredi Bruno Sequi, Marco Ennas, Andrea Benelli, Giovanni Guano, Antonio Luigi Pastore and Antonio Carbone
Cancers 2025, 17(1), 110; https://doi.org/10.3390/cancers17010110 - 1 Jan 2025
Cited by 1 | Viewed by 1063
Abstract
Background/Objectives: Radical cystectomy (RC) is the standard treatment for muscle-invasive and high-risk non-muscle-invasive bladder cancer, but it often results in significant functional impairments, including sexual and urinary dysfunction, adversely affecting quality of life (QoL). Sexual-sparing robotic-assisted radical cystectomy (RARC) has been introduced [...] Read more.
Background/Objectives: Radical cystectomy (RC) is the standard treatment for muscle-invasive and high-risk non-muscle-invasive bladder cancer, but it often results in significant functional impairments, including sexual and urinary dysfunction, adversely affecting quality of life (QoL). Sexual-sparing robotic-assisted radical cystectomy (RARC) has been introduced to mitigate these effects. This review evaluates the oncological and functional outcomes of sexual-sparing RARC in male and female patients. Methods: A systematic literature search identified 15 studies including 793 patients who underwent sexual-sparing RARC using techniques such as nerve-sparing, capsule-sparing, and pelvic organ-preserving approaches. Data on oncological and functional outcomes were analyzed. Results: Sexual-sparing RARC achieves oncological outcomes comparable to open RC, with negative surgical margin (NSM) rates exceeding 95% in most studies. RFS and CSS rates were robust, often surpassing 85% at intermediate follow-ups. Functional outcomes were also favorable, with continence rates exceeding 90% and erectile function recovery surpassing 70% in well-selected male patients. Female patients undergoing pelvic organ-preserving techniques demonstrated improved continence, preserved sexual function, and enhanced QoL. Patient selection emerged as critical, favoring those with organ-confined disease and good baseline function. Conclusions: Sexual-sparing RARC offers a promising balance between oncological control and functional preservation, making it an effective option for selected patients. Further research is needed to refine techniques and establish standardized protocols for broader adoption. Full article
(This article belongs to the Special Issue Urogenital Neoplasms Pathology)
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Other

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11 pages, 240 KiB  
Systematic Review
A Systematic Review of the Use of Surgical Checklists in Transurethral Resection of Bladder Tumour
by Abram Botros, Paul M. Rival, Ian D. Davis and Shomik Sengupta
Cancers 2024, 16(21), 3626; https://doi.org/10.3390/cancers16213626 - 27 Oct 2024
Viewed by 1184
Abstract
Context: Surgical checklists have previously been shown to improve surgical quality and patient outcomes. However, their use in transurethral resection of bladder tumour (TURBT), one of the most commonly performed urological procedures, has yet to be explored in depth. Objective: To evaluate the [...] Read more.
Context: Surgical checklists have previously been shown to improve surgical quality and patient outcomes. However, their use in transurethral resection of bladder tumour (TURBT), one of the most commonly performed urological procedures, has yet to be explored in depth. Objective: To evaluate the effect of surgical checklist implementation in TURBT on documentation quality, specimen quality, and oncological outcomes according to the existing literature. We then hope to develop an optimised TURBT checklist by identifying the most pertinent parameters for inclusion. Evidence acquisition: A literature search using PubMed was performed to identify literature pertaining to the use of surgical checklists in the context of TURBT. A systematic review was then performed on the 41 identified studies, of which six were included in the final analysis. Evidence synthesis: We explored three primary outcomes that arose from the literature, namely: (1) comprehensiveness of documentation; (2) resection quality; and (3) recurrence rates and recurrence-free survival (RFS). We found agreement in the literature that surgical checklist implementation does lead to an overall improvement in documentation. The effect of surgical checklists on resection quality and recurrence rates, however, was mixed in the literature, with some studies showing statistically significant improvements and others showing no significant change. Conclusions: There are multiple benefits to surgical checklist implementation in TURBT procedures. We propose an optimised 14-item surgical checklist that should be implemented in every TURBT report to ensure sufficient information documentation for risk stratification and post-operative management. Full article
(This article belongs to the Special Issue Urogenital Neoplasms Pathology)
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