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Updates on Urologic Oncology: From Diagnosis to Localized and Systemic Therapy Options (2nd Edition)

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

Deadline for manuscript submissions: 30 June 2026 | Viewed by 13361

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Dr. Giuseppe Palermo

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Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Interests: prostate cancer; bladder cancer; BPH
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of the Special Issue titled “Updates on Urologic Oncology: From Diagnosis to Localized and Systemic Therapy Options” https://www.mdpi.com/journal/cancers/special_issues/6DA892SP7G.

Urological malignancies are one of the leading causes of cancer-related deaths worldwide. The early and accurate diagnosis of these neoplasms can enable more effective and personalized management of the affected patients. Liquid biopsy is playing an increasingly prominent role in the diagnosis and prognosis of bladder and prostate cancer. New prognostic biomarkers are currently being studied in the context of renal cancer management. Moreover, the new minimally invasive surgical technologies enable the constant improvement of patients’ oncological and functional outcomes, just as immunotherapy represents a significant advance in the evolution of the treatment of major urological neoplasms, both localized and locally advanced. The purpose of this Special Issue is to summarize the latest innovations in the diagnostic and therapeutic management of urological neoplasms and the future perspectives that may be derived from current research.

Dr. Giuseppe Palermo
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 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

bladder cancer
prostate cancer
renal cancer
urologic cancer treatment
urologic cancer diagnosis
urologic cancer innovation
urologic neoplasm therapy
immunotherapy

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Published Papers (6 papers)

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Research

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10 pages, 199 KB

Open AccessArticle

Impact of Hypoalbuminemia on Morbidity and Mortality After Radical Cystectomy

by Sri Saran Manivasagam, Jay D. Raman and Matthew G. Kaag

Cancers 2026, 18(2), 313; https://doi.org/10.3390/cancers18020313 - 20 Jan 2026

Viewed by 173

Abstract

Objective: To evaluate the role of serum albumin in predicting surgical outcomes after radical cystectomy. Methods: Retrospective cohort analysis of adults who underwent radical cystectomy from 2019 to 2022 within the ACS NSQIP dataset. Patients were stratified into three groups based on preoperative serum albumin: <3.0 g/dL, 3.0–3.5 g/dL, and >3.5 g/dL. Primary outcomes were surgical site infections, wound disruption, reoperation rates, prolonged hospitalization, and 30-day mortality. Regression analyses assessed the impact of hypoalbuminemia (<3.5 g/dL) on outcomes. Results: In total, 6748 patients were included in the analysis. Distribution of preoperative albumin levels included 4.8% with albumin less than 3.0 gm/dL (Cohort A), 10.7% with albumin between 3.0 and 3.5 gm/dL (Cohort B), and 84.4% with albumin > 3.5 gm/dL (Cohort C). The incidence of superficial SSI (7.7%), deep SSI (2.2%), wound disruption (4.0%), unplanned reoperation (8.6%), and still in hospital at 30 days (5.5%) was significantly higher in Cohort A (p for all < 0.05). Moreover, 30-day mortality was significantly higher in Cohorts A and B, as compared to Cohort C (2.2% vs. 2.3% vs. 1.3%, p = 0.03). On multivariate logistic regression, albumin < 3.5 gm/dL was significantly associated with reoperation (OR = 1.39, p = 0.031), prolonged hospitalization (OR = 1.28, p = 0.038), and 30-day mortality (OR = 1.74, p = 0.025). Conclusions: Preoperative hypoalbuminemia is independently associated with increased morbidity and mortality following radical cystectomy. Given its modifiable nature, serum albumin should be considered a key target for preoperative optimization. Full article

(This article belongs to the Special Issue Updates on Urologic Oncology: From Diagnosis to Localized and Systemic Therapy Options (2nd Edition))

12 pages, 1081 KB

Open AccessArticle

A Comparative Analysis of the Functional Outcomes Between Retzius-Sparing and Conventional Robot-Assisted Radical Prostatectomy Using the Expanded Prostate Cancer Index Composite

by Soichiro Shimura, Dai Koguchi, Ken-ichi Tabata, Izuru Shiba, Yutaka Shiono, Kohei Mori, Shuhei Hirano, Masaomi Ikeda, Hideyasu Tsumura, Daisuke Ishii and Kazumasa Matsumoto

Cancers 2025, 17(24), 3913; https://doi.org/10.3390/cancers17243913 - 7 Dec 2025

Viewed by 485

Abstract

Background/Objectives: Robot-assisted radical prostatectomy (RARP) has emerged as the predominant surgical approach globally, and various techniques have been proposed to improve functional outcomes. Despite these advances, however, functional impairment associated with surgery remains a major concern that affects patients’ quality of life. Retzius-sparing RARP (RS-RARP) has been proposed as a surgical technique to preserve the Retzius space, and increasing evidence has demonstrated its effectiveness. However, the effect of RS-RARP on other functions remains unknown. Although some reports show the positive effect of Retzius-sparing RARP (RS-RARP) on urinary incontinence, the effects on other functions remain unknown. Methods: The present study retrospectively analyzed 132 patients who underwent RARP at Kitasato University Hospital between January 2020 and July 2021 (49 and 83 patients in the RS-RARP and conventional RARP groups, respectively). We compared the functional outcomes of RS-RARP and conventional RARP (C-RARP) using the Expanded Prostate Cancer Index Composite (EPIC). In addition, sexual function was compared among patients who underwent nerve-sparing procedures. Results: Our findings revealed that, even at 12 months postoperatively, RS-RARP demonstrated significant preservation of urinary continence (p < 0.01) and sexual function compared to C-RARP (p = 0.03). No significant differences were observed in the bowel or hormonal domains. Even in patients who underwent nerve-sparing surgery, the EPIC score 12 months postoperatively was significantly higher with RS-RARP than with C-RARP (p < 0.01). RS-RARP tended to result in positive surgical margins more often than C-RARP (RS-RARP: 44.9%, C-RARP: 28.9%, p = 0.06), without affecting the rate of biochemical recurrence (RS-RARP: 14.2%, C-RARP: 15.7%, p = 0.81). Conclusions: Our results suggest a potential advantage of RS-RARP in preserving both urinary and sexual function. Full article

(This article belongs to the Special Issue Updates on Urologic Oncology: From Diagnosis to Localized and Systemic Therapy Options (2nd Edition))

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12 pages, 1937 KB

Open AccessArticle

Cell Models of Castration Resistant and High Dose Testosterone-Resistant Prostate Cancer Recapitulate the Heterogeneity of Response Observed in Clinical Practice

by Laura S. Graham, Lih-Jen Su, Andrew Nicklawsky, Frances Xiuyan Feng, David Orlicky, Joseph Petraccione, Maren Salzmann-Sullivan, Steven K. Nordeen and Thomas W. Flaig

Cancers 2025, 17(4), 593; https://doi.org/10.3390/cancers17040593 - 10 Feb 2025

Viewed by 1995

Abstract

The use of supraphysiologic testosterone, particularly when alternated with an anti-androgen agent in men with metastatic castration-resistant prostate cancer (CRPC), has demonstrated promising results in clinical trials. As the use of this therapy in clinical practice is more widely adopted, there will be a growing need to understand the mechanisms of resistance. To that end, we independently derived three separate cell models of testosterone-sensitive CRPC. From each CRPC line, high dose testosterone-resistance (HTR) lines were selected. We demonstrated the differential response of the three CRPC lines to a high dose of testosterone in vitro and in vivo. We subsequently demonstrated the resistance of the HTR lines to testosterone and varying responses to testosterone withdrawal in vivo. The heterogeneity in responses to hormonal manipulation is correlated with varying levels of androgen receptor expression within the population. Overall, we show that we have developed three models of HTR that can be used to study the mechanisms of high dose testosterone resistance and identify potential therapeutic targets. Full article

(This article belongs to the Special Issue Updates on Urologic Oncology: From Diagnosis to Localized and Systemic Therapy Options (2nd Edition))

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Review

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14 pages, 248 KB

Open AccessReview

A Narrative Review of Treatment Options for Patients with Node-Positive Disease After Radical Prostatectomy: Current Evidence and Controversies

by Paolo Zaurito, Andrea Cosenza, Leonardo Quarta, Pietro Scilipoti, Mattia Longoni, Alfonso Santangelo, Alessandro Viti, Abigail Gettman, Francesco Barletta, Simone Scuderi, Vito Cucchiara, Armando Stabile, Francesco Montorsi, Alberto Briganti and Giorgio Gandaglia

Cancers 2025, 17(17), 2792; https://doi.org/10.3390/cancers17172792 - 27 Aug 2025

Cited by 1 | Viewed by 1694

Abstract

Purpose of Review: In approximately 10–15% of patients with prostate cancer (PCa), pathological lymph node metastases (pN1) are detected at radical prostatectomy (RP). The aim of this review is to describe the various treatment options for pN1 patients, with a focus on the most recent evidence reported in the literature. Evidence Synthesis: Due to the lack of prospective studies, several retrospective analyses were conducted according to different types of treatment. Most common strategies are represented by observation plus early salvage radiotherapy (RT) in case of PSA rising, adjuvant androgen deprivation therapy (ADT) alone, or adjuvant RT with or without ADT. Patients with pN1 disease and favorable disease characteristics (lower T stage and ISUP ≤ 2 at RP, <3 metastatic nodes at pathology) have a similar overall mortality risk if observed with PSA testing and eventual use of early salvage RT compared to patients directly treated with adjuvant RT with or without ADT. While conflicting results in terms of survival benefit were reported for the use of adjuvant ADT only, several studies showed an overall survival benefit in patients with pN1 disease treated with adjuvant RT when high-risk features (such as an increasing number of positive nodes, ISUP > 3) were detected at RP. Lastly, few studies analyzed the rate of adverse events following adjuvant ADT or RT, leaving the issue of treatment-related side effects still open. Summary: There is no clearly established standard of care for men with pN1 PCa, and disease characteristics should guide the choice of optimal post-operative management for these patients. Prospective data and clinical trials are clearly needed to define the most effective therapeutic strategy. Full article

(This article belongs to the Special Issue Updates on Urologic Oncology: From Diagnosis to Localized and Systemic Therapy Options (2nd Edition))

21 pages, 966 KB

Open AccessReview

A Personalized Approach for Oligometastatic Prostate Cancer: Current Understanding and Future Directions

by Parissa Alerasool, Susu Zhou, Eric Miller, Jonathan Anker, Brandon Tsao, Natasha Kyprianou and Che-Kai Tsao

Cancers 2025, 17(1), 147; https://doi.org/10.3390/cancers17010147 - 5 Jan 2025

Cited by 2 | Viewed by 4989

Abstract

Oligometastatic prostate cancer (OMPC) represents an intermediate state in the progression from localized disease to widespread metastasis when the radiographically significant sites are limited in number and location. With no clear consensus on a definition, its diagnostic significance and associated optimal therapeutic approach remain controversial, posing a significant challenge for clinicians. The current standard of care for metastatic disease is to start systemic therapy; however, active surveillance and targeted radiotherapy have become attractive options to mitigate the long-term effects of androgen deprivation therapy (ADT). Furthermore, evolving biomarker methodologies may further define optimal treatment selection. In this review, we summarize the current understanding that guides the treatment of OMPC, with a focus on how host response can be an important contributing factor. Evolving scientific understanding and clinical development will continue to shape the landscape of treatment strategies for this distinct disease state. Full article

(This article belongs to the Special Issue Updates on Urologic Oncology: From Diagnosis to Localized and Systemic Therapy Options (2nd Edition))

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16 pages, 616 KB

Open AccessReview

Relationship Between Loss of Y Chromosome and Urologic Cancers: New Future Perspectives

by Pierluigi Russo, Francesco Pio Bizzarri, Giovanni Battista Filomena, Filippo Marino, Roberto Iacovelli, Chiara Ciccarese, Luigi Boccuto, Mauro Ragonese, Filippo Gavi, Francesco Rossi, Cosimo Savoia, Paolo Pietro Suraci, Roberto Falabella, Savio Domenico Pandolfo, Luigi Napolitano, Chiara Leoni, Valentina Trevisan, Giuseppe Palermo, Marco Racioppi, Emilio Sacco, Stijn Muselaers and Nazario Foschi Show full author list Hide full author list

Cancers 2024, 16(22), 3766; https://doi.org/10.3390/cancers16223766 - 8 Nov 2024

Cited by 40 | Viewed by 3275

Abstract

Background: The Y chromosome (ChrY) is essential for male sex determination and spermatogenesis. However, recent studies have revealed its broader role in various physiological processes and disease susceptibility, including cancer. Methods: A comprehensive literature review was conducted using databases like MEDLINE, Scopus, Web of Science, and Google Scholar. The review included clinical and preclinical studies in animals and humans focusing on the role of LoY in urological tumors. Data on the frequency of LoY, its clinical implications, and underlying mechanisms were extracted and analyzed. Results: The evidence suggests that LoY is associated with an increased risk of urologic neoplasms, potentially serving as an early marker of genomic instability. Studies reveal that LoY in urologic cancers correlates with worse survival outcomes and may contribute to tumor progression. LoY may interfere with chromatin structure and epigenetic regulation, suggesting its role as a contributor to early tumorigenesis. Conclusions: LoY appears to be a structural aberration with unique biological and clinical relevance in urologic cancers, possibly serving as a biomarker for genomic instability. Further research is necessary to identify specific Y-linked genes affected by LoY, potentially informing targeted therapies and early diagnostic strategies for these cancers. Full article

(This article belongs to the Special Issue Updates on Urologic Oncology: From Diagnosis to Localized and Systemic Therapy Options (2nd Edition))

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