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Cancers
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Innovative Diagnostic and Therapeutic Approaches in Urologic Oncology
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Innovative Diagnostic and Therapeutic Approaches in Urologic Oncology

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 5516

Special Issue Editors

Dr. Francesco Sessa

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Guest Editor
1. Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
2. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
Interests: urologic oncology; prostate cancer
Dr. Riccardo Campi

E-Mail
Guest Editor
1. Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
2. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
Interests: urologic oncology; renal cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Enrico Checcucci

E-Mail Website
Guest Editor
Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142, km 3, 95, 10060 Candiolo, Italy
Interests: urologic oncology; prostate cancer; urotechnology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of urologic oncology is rapidly evolving, embracing a multidisciplinary mindset and requiring collaboration from multiple specialties to optimize value-base care for patients.

In this special Issue we aim to collect papers covering all aspects related to the diagnosis and treatment of genitourinary malignancies (prostate cancer, urothelial cancer, renal cancer, testis cancer and penile cancer), with the objective to provide readers with an updated overview of the current diagnostic and therapeutic strategies for patients with such cancers.

We are pleased to invite you to contribute original articles, or narrative/systematic reviews focused on timely and clinically relevant aspects of the diagnosis and treatment of genitourinary cancers.

We look forward to receiving your contributions. 

Dr. Francesco Sessa
Dr. Riccardo Campi
Dr. Enrico Checcucci
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 short 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

  • prostate cancer
  • urothelial cancer
  • renal cancer
  • penile cancer
  • testicular cancer

Published Papers (5 papers)

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Research

11 pages, 1686 KiB  
Article
Morbidity of Transrectal MRI-Fusion Targeted Prostate Biopsy at a Tertiary Referral Academic Centre: An Audit to Guide the Transition to the Transperineal Approach
by Andrea Alberti, Rossella Nicoletti, Paolo Polverino, Anna Rivetti, Edoardo Dibilio, Giulio Raffaele Resta, Pantelis Makrides, Corso Caneschi, Andrea Cifarelli, Antonino D’Amico, Luisa Moscardi, Mattia Lo Re, Federico Peschiera, Maria Lucia Gallo, Alessio Pecoraro, Arcangelo Sebastianelli, Lorenzo Masieri, Mauro Gacci, Sergio Serni, Riccardo Campi and Francesco Sessaadd Show full author list remove Hide full author list
Cancers 2023, 15(24), 5798; https://doi.org/10.3390/cancers15245798 - 11 Dec 2023
Cited by 1 | Viewed by 782
Abstract
Despite transrectal prostate biopsy (TRPB) being still widespread globally, the EAU Guidelines strongly recommend the transperineal approach, due to the reported lower infectious risk. Our study aims to evaluate the impact of a standardized clinical pathway for TRPB on post-operative complications. We prospectively [...] Read more.
Despite transrectal prostate biopsy (TRPB) being still widespread globally, the EAU Guidelines strongly recommend the transperineal approach, due to the reported lower infectious risk. Our study aims to evaluate the impact of a standardized clinical pathway for TRPB on post-operative complications. We prospectively collected data from all patients undergoing mpMRI-targeted TRPB at our Academic Centre from January 2020 to December 2022. All patients followed a standardized, structured multistep pathway. Post-procedural complications were collected and classified according to the Clavien–Dindo (CD) Classification. Among 458 patients, post-procedural adverse events were reported by 203 (44.3%), of which 161 (35.2%) experienced CD grade 1 complications (hematuria [124, 27.1%], hematochezia [22, 4.8%], hematospermia [14, 3.1%], or a combination [20, 4.4%]), and 45 (9.0%) reported CD grade 2 complications (acute urinary retention or hematuria needing catheterization, as well as urinary tract infections, of which 2 cases required hospitalization). No major complications, including sepsis, were observed. At uni- and multivariable analysis, age > 70 years and BMI > 25 kg/ m2 for patients were identified as predictors of post-operative complications. The results of our study confirm that TRPB is a safe and cost-effective procedure with a low risk of severe adverse events in experienced hands and following a standardized pathway. Full article
(This article belongs to the Special Issue Innovative Diagnostic and Therapeutic Approaches in Urologic Oncology)
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10 pages, 2023 KiB  
Article
The Development and External Validation of Artificial Intelligence-Driven MRI-Based Models to Improve Prediction of Lesion-Specific Extraprostatic Extension in Patients with Prostate Cancer
by Ingeborg van den Berg, Timo F. W. Soeterik, Erik J. R. J. van der Hoeven, Bart Claassen, Wyger M. Brink, Diederik J. H. Baas, J. P. Michiel Sedelaar, Lizette Heine, Jim Tol, Jochem R. N. van der Voort van Zyp, Cornelis A. T. van den Berg, Roderick C. N. van den Bergh, Jean-Paul A. van Basten and Harm H. E. van Melick
Cancers 2023, 15(22), 5452; https://doi.org/10.3390/cancers15225452 - 17 Nov 2023
Cited by 1 | Viewed by 1111
Abstract
Adequate detection of the histopathological extraprostatic extension (EPE) of prostate cancer (PCa) remains a challenge using conventional radiomics on 3 Tesla multiparametric magnetic resonance imaging (3T mpMRI). This study focuses on the assessment of artificial intelligence (AI)-driven models with innovative MRI radiomics in [...] Read more.
Adequate detection of the histopathological extraprostatic extension (EPE) of prostate cancer (PCa) remains a challenge using conventional radiomics on 3 Tesla multiparametric magnetic resonance imaging (3T mpMRI). This study focuses on the assessment of artificial intelligence (AI)-driven models with innovative MRI radiomics in predicting EPE of prostate cancer (PCa) at a lesion-specific level. With a dataset encompassing 994 lesions from 794 PCa patients who underwent robot-assisted radical prostatectomy (RARP) at two Dutch hospitals, the study establishes and validates three classification models. The models were validated on an internal validation cohort of 162 lesions and an external validation cohort of 189 lesions in terms of discrimination, calibration, net benefit, and comparison to radiology reporting. Notably, the achieved AUCs ranged from 0.86 to 0.91 at the lesion-specific level, demonstrating the superior accuracy of the random forest model over conventional radiological reporting. At the external test cohort, the random forest model was the best-calibrated model and demonstrated a significantly higher accuracy compared to radiological reporting (83% vs. 67%, p = 0.02). In conclusion, an AI-powered model that includes both existing and novel MRI radiomics improves the detection of lesion-specific EPE in prostate cancer. Full article
(This article belongs to the Special Issue Innovative Diagnostic and Therapeutic Approaches in Urologic Oncology)
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12 pages, 4126 KiB  
Article
Prognostic Value of the De Ritis Ratio for Overall Survival in Patients with Metastatic Castration-Resistant Prostate Cancer Undergoing [177Lu]Lu-PSMA-617 Radioligand Therapy
by Sebastian Gaal, Kai Huang, Julian M. M. Rogasch, Hans V. Jochens, Maria De Santis, Barbara Erber and Holger Amthauer
Cancers 2023, 15(20), 4907; https://doi.org/10.3390/cancers15204907 - 10 Oct 2023
Viewed by 891
Abstract
The De Ritis ratio (=aspartate transaminase/alanine transaminase) has shown prognostic value in different cancer types. This is the first such analysis in prostate cancer patients undergoing radioligand therapy (RLT) with [177Lu]Lu-PSMA-617. This retrospective monocentric analysis included 91 patients with a median [...] Read more.
The De Ritis ratio (=aspartate transaminase/alanine transaminase) has shown prognostic value in different cancer types. This is the first such analysis in prostate cancer patients undergoing radioligand therapy (RLT) with [177Lu]Lu-PSMA-617. This retrospective monocentric analysis included 91 patients with a median of 3 RLT cycles (range 1–6) and median cumulative activity of 17.3 GBq. Univariable Cox regression regarding overall survival (OS) included age, different types of previous treatment, metastatic patterns and different laboratory parameters before RLT. Based on multivariable Cox regression, a prognostic score was derived. Seventy-two patients (79%) died (median follow-up in survivors: 19.8 months). A higher number of previous chemotherapy lines, the presence of liver metastases, brain metastases, a higher tumor load on PSMA-PET, a higher prostate-specific antigen (PSA) level, lower red blood cell count, lower hemoglobin, higher neutrophil-lymphocyte ratio and higher De Ritis ratio were associated with shorter OS (each p < 0.05). In multivariable Cox, a higher number of chemotherapy lines (range, 0–2; p = 0.036), brain metastases (p < 0.001), higher PSA (p = 0.004) and higher De Ritis ratio before RLT (hazard ratio, 1.27 per unit increase; p = 0.023) remained significant. This prognostic score separated five groups with a significantly different median OS ranging from 4.9 to 28.1 months (log-rank test, p < 0.001). If validated independently, the De Ritis ratio could enhance multifactorial models for OS after RLT. Full article
(This article belongs to the Special Issue Innovative Diagnostic and Therapeutic Approaches in Urologic Oncology)
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12 pages, 1018 KiB  
Article
Outcomes of a Diagnostic Pathway for Prostate Cancer Based on Biparametric MRI and MRI-Targeted Biopsy Only in a Large Teaching Hospital
by Leonor J. Paulino Pereira, Daan J. Reesink, Peter de Bruin, Giorgio Gandaglia, Erik J. R. J. van der Hoeven, Giancarlo Marra, Anne Prinsen, Pawel Rajwa, Timo Soeterik, Veeru Kasivisvanathan, Lieke Wever, Fabio Zattoni, Harm H. E. van Melick and Roderick C. N. van den Bergh
Cancers 2023, 15(19), 4800; https://doi.org/10.3390/cancers15194800 - 29 Sep 2023
Viewed by 979
Abstract
Background: Diagnostic pathways for prostate cancer (PCa) balance detection rates and burden. MRI impacts biopsy indication and strategy. Methods: A prospectively collected cohort database (N = 496) of men referred for elevated PSA and/or abnormal DRE was analyzed. All underwent biparametric MRI (3 [...] Read more.
Background: Diagnostic pathways for prostate cancer (PCa) balance detection rates and burden. MRI impacts biopsy indication and strategy. Methods: A prospectively collected cohort database (N = 496) of men referred for elevated PSA and/or abnormal DRE was analyzed. All underwent biparametric MRI (3 Tesla scanner) and ERSPC prostate risk-calculator. Indication for biopsy was PIRADS ≥ 3 or risk-calculator ≥ 20%. Both targeted (cognitive-fusion) and systematic cores were combined. A hypothetical full-MRI-based pathway was retrospectively studied, omitting systematic biopsies in: (1) PIRADS 1–2 but risk-calculator ≥ 20%, (2) PIRADS ≥ 3, receiving targeted biopsy-cores only. Results: Significant PCa (GG ≥ 2) was detected in 120 (24%) men. Omission of systematic cores in cases with PIRADS 1–2 but risk-calculator ≥ 20%, would result in 34% less biopsy indication, not-detecting 7% significant tumors. Omission of systematic cores in PIRADS ≥ 3, only performing targeted biopsies, would result in a decrease of 75% cores per procedure, not detecting 9% significant tumors. Diagnosis of insignificant PCa dropped by 52%. PCa undetected by targeted cores only, were ipsilateral to MRI-index lesions in 67%. Conclusions: A biparametric MRI-guided PCa diagnostic pathway would have missed one out of six cases with significant PCa, but would have considerably reduced the number of biopsy procedures, cores, and insignificant PCa. Further refinement or follow-up may identify initially undetected cases. Center-specific data on the performance of the diagnostic pathway is required. Full article
(This article belongs to the Special Issue Innovative Diagnostic and Therapeutic Approaches in Urologic Oncology)
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22 pages, 11614 KiB  
Article
Netrin Family Genes as Prognostic Markers and Therapeutic Targets for Clear Cell Renal Cell Carcinoma: Netrin-4 Acts through the Wnt/β-Catenin Signaling Pathway
by Shuai Ke, Jiayu Guo, Qinghua Wang, Haoren Shao, Mu He, Tao Li, Tao Qiu and Jia Guo
Cancers 2023, 15(10), 2816; https://doi.org/10.3390/cancers15102816 - 18 May 2023
Cited by 1 | Viewed by 1318
Abstract
Clear cell renal cell carcinoma (ccRCC, or KIRC) is the most common type of kidney cancer, originating within the renal cortex. The current outcomes for early diagnosis and late treatment of ccRCC are unsatisfactory. Therefore, it is important to explore tumor biomarkers and [...] Read more.
Clear cell renal cell carcinoma (ccRCC, or KIRC) is the most common type of kidney cancer, originating within the renal cortex. The current outcomes for early diagnosis and late treatment of ccRCC are unsatisfactory. Therefore, it is important to explore tumor biomarkers and therapeutic opportunities for ccRCC. In this study, we used bioinformatics methods to systematically evaluate the expression and prognostic value of Netrin family genes in ccRCC. Through our analysis, three potential biomarkers for ccRCC were identified, namely NTNG1, NTNG2, and NTN4. Moreover, we performed in vitro and in vivo experiments to explore the possible biological roles of NTN4 and found that NTN4 could regulate ccRCC development through Wnt/β-catenin signaling. We elucidate the molecular mechanism by which NTN4 modulates β-catenin expression and nuclear translocation to inhibit ccRCC progression, providing a new theoretical basis for developing therapeutic targets for ccRCC. Thus, we suggest that Netrin-related studies may offer new directions for the diagnosis, treatment, and prognosis of ccRCC patients. Full article
(This article belongs to the Special Issue Innovative Diagnostic and Therapeutic Approaches in Urologic Oncology)
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