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Robot-Assisted Surgery for Urologic Cancer
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Robot-Assisted Surgery for Urologic Cancer

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

Deadline for manuscript submissions: 15 March 2026 | Viewed by 2667

Special Issue Editors

Dr. Gabriele Sorce

E-Mail Website
Guest Editor
1. Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
2. ORSI Academy, Melle, Belgium
3. Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
Interests: prostate cancer
Dr. Francesco Pellegrino

E-Mail Website
Guest Editor
Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
Interests: Erectile dysfunction; prostate cancer; prostate biopsy
Dr. Ettore Di Trapani

E-Mail Website
Guest Editor
Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
Interests: kidney cancer; prostate cancer; urothelial cancer

Special Issue Information

Dear Colleagues,

This Special Issue, "Robot-Assisted Surgery for Urologic Cancer", highlights the transformative role of robotic technology in urologic oncology. Robot-assisted surgery has become a cornerstone for treating cancers such as prostate, kidney, and bladder cancers, offering enhanced precision, reduced invasiveness, and superior patient outcomes compared to traditional techniques. This Issue will delve into topics such as technical innovations, an analysis of the outcomes, and the integration of artificial intelligence into robotic systems.

A key focus will be placed on the training and education required to develop surgical expertise, addressing challenges such as steep learning curves, simulator-based training, and accreditation standards for robotic surgeons. Leading experts will also explore cost effectiveness, patient selection criteria, and long-term oncological and functional outcomes. Emerging trends, including single-port robotic surgery and advanced imaging integration, will be examined for their potential to further refine surgical precision. By combining clinical insights with perspectives on training and technological advancements, this Special Issue aims to foster a comprehensive understanding of the clinical, educational, and ethical implications of robot-assisted surgery in urologic oncology, serving as a valuable resource for surgeons, researchers, and healthcare policymakers.

Dr. Gabriele Sorce
Dr. Francesco Pellegrino
Dr. Ettore Di Trapani
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

  • robot-assisted surgery
  • urologic oncology
  • minimally invasive surgery
  • prostate cancer surgery
  • kidney cancer surgery
  • bladder cancer surgery
  • robotic platforms
  • robotic surgery training

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Published Papers (3 papers)

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Research

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13 pages, 2192 KB  
Article
Robot-Assisted Radical Prostatectomy for Locally Advanced Prostate Cancer: Oncological Potential and Limitations as the Primary Treatment
by Noriyoshi Miura, Masaki Shimbo, Kensuke Shishido, Shota Nobumori, Naoya Sugihara, Takatora Sawada, Shunsuke Haga, Haruna Arai, Keigo Nishida, Osuke Arai, Tomoya Onishi, Ryuta Watanabe, Kenichi Nishimura, Tetsuya Fukumoto, Yuki Miyauchi, Tadahiko Kikugawa, Takato Nishino, Fumiyasu Endo, Kazunori Hattori and Takashi Saika
Cancers 2025, 17(20), 3286; https://doi.org/10.3390/cancers17203286 - 10 Oct 2025
Viewed by 282
Abstract
Background: Locally advanced prostate cancer (PCa) is commonly treated with multimodal therapy; however, long-term outcomes of surgery alone are poorly defined. We investigated the potential and limitations of robot-assisted radical prostatectomy (RARP) as primary treatment without perioperative systemic therapy in patients with locally [...] Read more.
Background: Locally advanced prostate cancer (PCa) is commonly treated with multimodal therapy; however, long-term outcomes of surgery alone are poorly defined. We investigated the potential and limitations of robot-assisted radical prostatectomy (RARP) as primary treatment without perioperative systemic therapy in patients with locally advanced PCa. Methods: We retrospectively analyzed 258 patients who underwent RARP with extended pelvic lymph node dissection between 2012 and 2022 with locally advanced PCa, defined as present if at least one of the following was met: clinical stage cT3b–T4; primary Gleason pattern 5; >4 biopsy cores with Grade Group 4 or 5; or more than one NCCN high-risk characteristic. Patients who received neoadjuvant or adjuvant therapy were excluded. Endpoints included biochemical recurrence-free survival, metastasis-free survival, cancer-specific survival, and predictors of persistent PSA. Results: Median follow-up was 60.6 months. Pathological stage ≥ pT3a occurred in 63.6% and nodal involvement (pN1) in 27.1%. Five-year BRFS, MFS, and CSS were 36.6%, 88.9%, and 98.3%, respectively. Persistent PSA occurred in 21.3%. Preoperative predictors included PSA > 40 ng/mL, clinical stage ≥ cT3a, and >4 biopsy cores with a Gleason score of 8–10; patients with ≥2 features had significantly poorer BRFS and MFS. Postoperative predictors of recurrence were pathological stage, lymphovascular invasion, and nodal involvement. Conclusions: RARP alone provided durable long-term cancer control in selected men with locally advanced PCa, whereas patients with multiple adverse features were unlikely to be cured with surgery alone. Careful risk stratification may identify candidates for surgical monotherapy and help avoid overtreatment, while others may benefit from multimodal therapy. Full article
(This article belongs to the Special Issue Robot-Assisted Surgery for Urologic Cancer)
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11 pages, 441 KB  
Article
Adverse In-Hospital Outcomes Following Robot-Assisted vs. Open Radical Prostatectomy in Quadragenarians
by Fabian Falkenbach, Francesco Di Bello, Natali Rodriguez Peñaranda, Mattia Longoni, Andrea Marmiroli, Quynh Chi Le, Calogero Catanzaro, Michele Nicolazzini, Zhe Tian, Jordan A. Goyal, Nicola Longo, Stefano Puliatti, Riccardo Schiavina, Carlotta Palumbo, Gennaro Musi, Felix K. H. Chun, Alberto Briganti, Fred Saad, Shahrokh F. Shariat, Gisa Mehring, Lars Budäus, Markus Graefen and Pierre I. Karakiewiczadd Show full author list remove Hide full author list
Cancers 2025, 17(7), 1193; https://doi.org/10.3390/cancers17071193 - 31 Mar 2025
Cited by 1 | Viewed by 886
Abstract
Background/Objectives: Adverse in-hospital outcomes at radical prostatectomy have not been specifically addressed in young patients aged 40–49 years (quadragenarians). Additionally, no comparison between robot-assisted (RARP) vs. open radical prostatectomy (ORP) has been reported in this population. Methods: Descriptive analyses, propensity score [...] Read more.
Background/Objectives: Adverse in-hospital outcomes at radical prostatectomy have not been specifically addressed in young patients aged 40–49 years (quadragenarians). Additionally, no comparison between robot-assisted (RARP) vs. open radical prostatectomy (ORP) has been reported in this population. Methods: Descriptive analyses, propensity score matching (PSM), and multivariable logistic/Poisson regression models addressed quadragenarians undergoing RARP or ORP within the National Inpatient Sample (2009–2019). Results: Of 5426 quadragenarians, 4083 (75.2%) and 1343 (24.8%) underwent RARP and ORP, respectively. The proportion of RARP increased from 68.1 to 84.5% (2009–2019, EAPC: +2.8%, p < 0.001). Adverse in-hospital outcomes after RARP were invariably lower than those after ORP. Specifically, the rates of overall complications (7.8 vs. 13.4%, Δ −5.6%, multivariable odds ratio (OR): 0.54), blood transfusions (1.2 vs. 6.3%, Δ −5.1%, OR: 0.21), and length of stay (LOS) > 2 days (10.6 vs. 28.7%, Δ −18.1%, OR: 0.32) were lower after RARP than after ORP (all p < 0.001). After additional one-to-one PSM between ORP and RARP patients, virtually the same results were reported (overall complications: 7.0 vs. 13.4%, Δ −6.4%, OR: 0.49; blood transfusion rates: 1.5 vs. 6.3%, Δ −4.8%, OR: 0.23; LOS > 2 days: 10.9 vs. 28.7%, Δ −17.8%, OR: 0.30). Conversely, RARP use resulted in higher total hospital charges (USD 43,690 vs. 36,840, Δ USD +6850, IRR: 1.18; p < 0.001). Conclusions: Quadragenarians exhibited a more favorable adverse in-hospital outcome profile after RARP vs. ORP. These advantages are offset by a small, albeit significant, increase in total hospital charges. Full article
(This article belongs to the Special Issue Robot-Assisted Surgery for Urologic Cancer)
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Review

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17 pages, 270 KB  
Review
Single-Port vs. Multi-Port Robotic Surgery in Urologic Oncology: A Comparative Analysis of Current Evidence and Future Directions
by Stamatios Katsimperis, Lazaros Tzelves, Georgios Feretzakis, Themistoklis Bellos, Konstantinos Douroumis, Nikolaos Kostakopoulos and Andreas Skolarikos
Cancers 2025, 17(17), 2847; https://doi.org/10.3390/cancers17172847 - 29 Aug 2025
Cited by 1 | Viewed by 1208
Abstract
The evolution of robotic surgery in urologic oncology has led to the emergence of single-port (SP) robotic systems as a potential alternative to the widely adopted multi-port (MP) platforms. This narrative review provides a comprehensive comparison between SP and MP robotic systems, the [...] Read more.
The evolution of robotic surgery in urologic oncology has led to the emergence of single-port (SP) robotic systems as a potential alternative to the widely adopted multi-port (MP) platforms. This narrative review provides a comprehensive comparison between SP and MP robotic systems, the former of which received FDA approval in 2018 and CE marking in 2024, focusing on their application across radical prostatectomy, partial and radical nephrectomy, and radical cystectomy. Drawing from the most current literature, we examine perioperative outcomes, oncologic efficacy, postoperative recovery, and complication rates. The review highlights the technical challenges unique to SP surgery, including restricted triangulation, limited instrumentation, and a defined learning curve, while also emphasizing innovations such as transvesical prostatectomy and the Supine Anterior Retroperitoneal Access (SARA) approach. Additionally, we explore the potential impact of emerging technologies—such as artificial intelligence, augmented reality, and telesurgery—on the future of SP platforms. Despite early limitations, SP systems have demonstrated comparable safety and effectiveness in selected cases and may offer unique advantages in specific anatomical scenarios. Continued innovation, structured training, and robust long-term outcome data will be essential for the broader adoption and integration of SP robotic surgery in clinical practice. Full article
(This article belongs to the Special Issue Robot-Assisted Surgery for Urologic Cancer)
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