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Clinical Studies and Outcomes in Urologic Cancer

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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: 31 January 2026 | Viewed by 5364

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Dr. Nikolaos Pyrgidis

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Guest Editor

Department of Urology, LMU University Hospital, LMU Munich, 81377 Munich, Germany
Interests: urologic oncology; prostate cancer; bladder cancer

Special Issue Information

Dear Colleagues,

We are excited to announce a Special Issue focusing on clinical studies and outcomes in urologic cancer. This Special Issue will address the critical advances, challenges, and insights in the management of urologic cancers, especially the clinical outcomes associated with evolving therapies and interventions. Urologic cancers, including prostate, urothelial, and kidney cancer, continue to pose significant clinical and research challenges, making it essential to understand better their trends, treatment responses, and long-term patient outcomes.

This Special Issue aims to gather high-quality clinical studies and reviews that contribute to a comprehensive understanding of urologic cancer care. We seek to highlight innovative research that examines operative complications, survival outcomes, recurrence rates, quality of life, and novel therapeutic approaches, contributing to the journal’s commitment to advancing knowledge in oncology and urology. Original research articles and comprehensive reviews that fit within these themes (but are not limited to them) are welcomed.

We look forward to receiving your contributions and showcasing cutting-edge research in this pivotal area.

Dr. Nikolaos Pyrgidis
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

urologic cancer
clinical outcomes
prostate cancer
urothelial cancer
kidney cancer
survival analysis
treatment response
quality of life
novel therapies
oncology

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Published Papers (5 papers)

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Research

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11 pages, 852 KB

Open AccessArticle

The Future Is Bright for Women in Urologic Oncology: Trends over Two Decades

by Gabrielle R. Yankelevich, Reid DeMass, Luis G. Medina, Tara Sweeney, Robert L. Grubb, Stephen J. Savage and Matvey Tsivian

Cancers 2026, 18(2), 310; https://doi.org/10.3390/cancers18020310 - 20 Jan 2026

Viewed by 119

Abstract

Background/Objectives: The role of female surgeons in urology has been steadily increasing. We performed a contemporary review of American Board of Urology (ABU) case logs focused on oncologic procedures and evaluated the role of female surgeons over the past two decades. Methods: Operative logs from ABU examinees from 2003 to 2023 were analyzed. We identified open-approach (OA) and minimally invasive (MIS) radical nephrectomy (RN), partial nephrectomy (PN), radical nephroureterectomy (RNU), radical prostatectomy (RP), and adrenalectomy (RA) using CPT codes. Total case volumes as well as reported fellowship training were recorded and tabulated. The counts and proportions of OA and MIS procedures were analyzed over time and by surgeon gender. Results: From 2003 to 2023, 54,972 surgical procedures were reported to ABU with only 2.1% (1127) being performed by female surgeons. Of these, 32.5% (366) were OA and 67.5% (761) were MIS. Despite the low overall composition of female-performed procedures, the number of surgeries performed by females increased over time. Among female surgeons, the proportion of MIS surgeries increased over time, from 37.5% to 71.5% in 2003–2009 to 2017–2023, respectively. Females versus males performed comparably for OA for RN and RA; however, females performed more open PN, RNU, and RP than their male counterparts. Moreover, the number of procedures performed by oncology fellowship-trained females increased significantly. Conclusions: Our analysis of over twenty years of data submitted to the ABU indicates that the surgical volume of oncologic procedures by female urologists has been increasing. These findings demonstrate the increased contributions by female surgeons to the field urologic oncology. Full article

(This article belongs to the Special Issue Clinical Studies and Outcomes in Urologic Cancer)

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11 pages, 543 KB

Open AccessArticle

Prognostic Value of Preoperative Hemoglobin in Patients Undergoing Radical Prostatectomy for Localized Prostate Cancer

by Dominik Enderlin, Lea Hertelendy, Josias Bastian Grogg, Franz von Stauffenberg, Daniel Eberli and Cédric Poyet

Cancers 2025, 17(16), 2633; https://doi.org/10.3390/cancers17162633 - 12 Aug 2025

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Abstract

Background: Hemoglobin (Hb) has been identified to be an independent prognostic marker for oncological outcomes in several malignancies. However, the impact of Hb levels before radical prostatectomy (RP) in localized prostate cancer remains unclear. Methods: Preoperative Hb levels were retrospectively collected from patients, who underwent RP from 2016 to 2022. Hb levels were analyzed as continuous and binary variables. For binary analysis, the cohort was divided into high-Hb (≥150 g/L) and low-Hb (<150 g/L) groups using the median as a cutoff. We used Spearman rank correlation to assess possible associations between Hb and continuous variables and logistic regression for Hb and binary variables. To assess the impact of preoperative Hb on recurrence-free survival (RFS), adjuvant treatment free survival (TFS), and metastasis-free survival (MFS), univariate and multivariate Cox regression analyses were performed. Results: A total of 567 patients were included in the analysis. Higher Hb levels, both when analyzed as a continuous variable and when divided in high and low groups, were inversely correlated with age (p < 0.001) and the International Society of Urological Pathology (ISUP) grade (p = 0.005 or p = 0.028, respectively). Patients in the high-Hb group showed a decreased risk of extraprostatic disease (≥pT3) (odds ratio [OR] 0.71, 95%-CI: 0.50–0.99, p = 0.047). In univariate cox regression analysis, high-Hb patients had a significantly longer RFS compared to the low-Hb group (hazard ratio [HR] 0.64, 95%-CI: 0.44–0.92, p = 0.015). When adjusting for age, ISUP grade, positive surgical margin, prostate specific antigen, nodal status, and ≥pT3, this effect was no longer statistically significant (HR 0.76, 95%-CI 0.56–1.22, p = 0.178). Hb was not a significant prognostic factor for TFS or MFS. Conclusions: In this large cohort, lower preoperative Hb values were associated with a more aggressive tumor grading and shorter RFS. However, we were unable to identify Hb as an independent predictor of oncological survival outcomes. Full article

(This article belongs to the Special Issue Clinical Studies and Outcomes in Urologic Cancer)

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11 pages, 530 KB

Open AccessArticle

Perioperative Outcomes After Radical Nephrectomy with Inferior Vena Cava Thrombectomy

by Nikolaos Pyrgidis, Gerald Bastian Schulz, Christian G. Stief, Iulia Blajan, Troya Ivanova, Annabel Graser and Michael Staehler

Cancers 2025, 17(7), 1083; https://doi.org/10.3390/cancers17071083 - 24 Mar 2025

Cited by 3 | Viewed by 1426

Abstract

Background and Objective: We aimed to evaluate current trends and complications after radical nephrectomy with inferior vena cava (IVC) thrombectomy and to provide evidence on the role of the annual hospital caseload on perioperative outcomes. Methods: We used the GeRmAn Nationwide inpatient Data (GRAND), provided by the German Bureau of Statistics (2005–2022). All hospitals performing radical nephrectomy with IVC thrombectomy were subclassified based on their annual caseload to low- (<3 cases/year), intermediate- (3–9 cases/year), and high-volume centers (≥10 cases/year). We included 3608 patients. Key Findings and Limitations: Overall, 1880 (52%) patients underwent surgery in low-, 1466 (40%) in intermediate-, and 848 (8%) in high-volume centers. Most patients (3574, 99%) underwent open surgery. The number of patients undergoing radical nephrectomy with IVC thrombectomy has decreased in the last years. Patients undergoing surgery in low-, intermediate- and high-volume centers had similar baseline characteristics. Operation in high-volume centers, compared to low-volume centers, was associated with lower odds of intensive care unit admission (29% versus 45%, OR: 0.5, 95% CI: 0.4–0.7, p < 0.001) and a shorter hospital stay by 3.9 days (95% CI: 2.2–5.6, p < 0.001). Importantly, for every additional case performed annually, hospitals improve their perioperative outcomes in terms of mortality (p = 0.032), intensive care unit admissions (p = 0.002), acute kidney disease (p = 0.029), and length of hospital stay (p < 0.001). Conclusions and Clinical Implications: The present real-world data demonstrate that, for every additional case performed annually, hospitals improve their perioperative outcomes in terms of major perioperative complications. Full article

(This article belongs to the Special Issue Clinical Studies and Outcomes in Urologic Cancer)

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17 pages, 1035 KB

Open AccessArticle

Improving Risk Stratification in pT3 Upper Tract Urothelial Carcinoma: A Focus on Invasion Patterns

by Yung-Tai Chen, Hsiang-Ying Lee, Wen-Jeng Wu, Chih-Hung Lin, Yuan-Hong Jiang, Yu-Khun Lee, Kuan-Hsun Huang and Yao-Chou Tsai

Cancers 2025, 17(6), 923; https://doi.org/10.3390/cancers17060923 - 8 Mar 2025

Viewed by 1498

Abstract

Purpose: Existing T3 subclassifications for upper tract urothelial cancer (UTUC) are limited by heterogeneity and a primary focus on renal pelvis tumors. Our study aimed to propose a novel pT3 subclassification system specifically tailored to pT3 UTUC patients. Materials and Methods: This study analyzed 120 pT3 UTUC cases from a Taiwanese multicenter registry, using a standardized pathology report and a single pathologist for evaluation. Results: Univariate analysis revealed survival differences based on existing subclassifications. Multivariate analysis identified concurrent fat and parenchyma invasion as an independent predictor of worse overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Conclusions: This study proposes a novel pT3 subclassification incorporating fat and parenchyma invasion, applicable to all UTUC sites. This subclassification may improve risk stratification, guide treatment decisions, and ultimately enhance patient outcomes. Full article

(This article belongs to the Special Issue Clinical Studies and Outcomes in Urologic Cancer)

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Review

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15 pages, 614 KB

Open AccessReview

Using Artificial Intelligence as a Risk Prediction Model in Patients with Equivocal Multiparametric Prostate MRI Findings

by Abdullah Al-Khanaty, David Hennes, Arjun Guduguntla, Pablo Guerrero, Carlos Delgado, Eoin Dinneen, Elio Mazzone, Sree Appu, Damien Bolton, Renu S. Eapen, Declan G. Murphy, Nathan Lawrentschuk and Marlon L. Perera

Cancers 2026, 18(1), 28; https://doi.org/10.3390/cancers18010028 - 21 Dec 2025

Viewed by 529

Abstract

Introduction: PI-RADS 3 lesions represent a diagnostic grey zone on multiparametric MRI, with clinically significant prostate cancer (csPCa) detected in only 10–30%. Their equivocal nature leads to both unnecessary biopsies and missed cancers. Artificial intelligence (AI) has emerged as a potential tool to provide objective, reproducible risk prediction. This review summarises current evidence on AI for risk stratification in patients with indeterminate mpMRI findings, including clarification of key multicentre initiatives such as the PI-CAI (Prostate Imaging–Artificial Intelligence) study—a global benchmarking effort comparing AI systems against expert radiologists. Methods: A narrative review of PubMed and Embase (search updated to August 2025) was conducted using terms including “PI-RADS 3”, “radiomics”, “machine learning”, “deep learning”, and “artificial intelligence.” Eligible studies included those evaluating AI-based prediction of csPCa in PI-RADS 3 lesions using biopsy or long-term follow-up as reference standards. Both single-centre and multicentre studies were included, with emphasis on externally validated models. Results: Radiomics studies demonstrate that handcrafted features extracted from T2-weighted and diffusion-weighted imaging can distinguish benign tissue from csPCa, particularly in the transition zone, with area-under-the-ROC curves typically 0.75–0.82. Deep learning approaches—including convolutional neural networks and large-scale representation-learning frameworks—achieve higher performance and can reduce benign biopsy rates by 30–40%. Models that integrate imaging-based AI with clinical predictors such as PSA density further improve discrimination. The PI-CAI study, the largest international benchmark to date (>10,000 MRI exams), shows that state-of-the-art AI systems can match or exceed expert radiologists for csPCa detection across diverse scanners, centres, and populations, though prospective validation remains limited. Conclusions: AI shows strong potential to refine management of PI-RADS 3 lesions by reducing unnecessary biopsies, improving csPCa detection, and mitigating inter-reader variability. Translation into routine practice will require prospective multicentre validation, harmonised imaging protocols, and integration of AI outputs into clinical workflows with clear thresholds, decision support, and safety-net recommendations. Full article

(This article belongs to the Special Issue Clinical Studies and Outcomes in Urologic Cancer)

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