Urologic Oncology: Biomarkers, Diagnosis, and Management—2nd Edition

A Special Issue of Diagnostics (ISSN 2075-4418) belonging to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 June 2026) | Viewed by 1513

Editor

Special Issue Information

Dear Colleagues,

This Special Issue aims to comprehensively explore cutting-edge research in the field, with a particular focus on biomarkers, diagnostic advancements, and innovative management strategies. We invite contributions that examine the latest developments that shape our understanding of urologic oncology, fostering a collaborative exchange of insights to advance patient care. As we navigate the intricate landscape of urologic malignancies, this Special Issue endeavors to spotlight emerging trends and breakthroughs, catalyzing impactful discussions within our scientific community.

Dr. Roberto Contieri
Guest Editor

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Keywords

  • urologic oncology
  • biomarkers
  • diagnosis
  • management
  • urothelial carcinoma
  • prostate cancer
  • kidney cancer
  • testis cancer
  • penile cancer

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Published Papers (2 papers)

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18 pages, 1268 KB  
Article
Evaluation of the Proliferation Marker Ki-67 for Improved Risk Stratification of Prostate Cancer Patients Under Active Surveillance
by Viktoria Schütz, Maresa Rothermel, Adam Kaczorowski, Svenja Dieffenbacher, Sarah Heike Böning, Constantin Schwab, Albrecht Stenzinger, Johannes Huber, Anette Duensing, Markus Hohenfellner and Stefan Duensing
Diagnostics 2026, 16(7), 975; https://doi.org/10.3390/diagnostics16070975 - 25 Mar 2026
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Abstract
Background/Objectives: Active surveillance (AS) is a viable option for patients with low-risk/low-burden prostate cancer (PCa). Approximately 40–50% of patients will develop disease progression and conversion to active treatment. Therefore, better risk stratification may aid patients and urologists to improve decision making. Herein, [...] Read more.
Background/Objectives: Active surveillance (AS) is a viable option for patients with low-risk/low-burden prostate cancer (PCa). Approximately 40–50% of patients will develop disease progression and conversion to active treatment. Therefore, better risk stratification may aid patients and urologists to improve decision making. Herein, the proliferation marker Ki-67 was examined for its prognostic potential in AS patients. Methods: Fifty-nine patients were included. Median follow-up time was 58 months (range, 10–162 months). Tumor-bearing biopsies were evaluated using immunohistochemistry (IHC) staining for Ki-67 and evaluated using digital imaging analysis to determine the percentage of Ki-67-positive PCa cells per biopsy. Results: Thirty-three of 59 patients (55.9%) developed progression. Thirty-one of 59 patients (52.5%) showed Ki-67-positive biopsies (median 0.8%; range, 0–11.9%). The median of Ki-67-positive cells was 1.5% (range, 0–11.9%) in patients with and 0% (range, 0–6.3%) in patients without progression. Comparing patients with Ki-67-positive and Ki-67-negative biopsies showed a worse progression free survival (PFS) in patients with Ki-67-positive biopsies after a period of 15 months, however, without reaching statistical significance (p = 0.071). A 5% threshold for Ki-67 positivity led to a significant difference in PFS. Further exploratory analysis revealed that patients with Ki-67-positive biopsies and aged ≥65 years or with >1 tumor-bearing biopsy show a significantly worse outcome (p = 0.038 and p = 0.037, respectively). Conclusions: Our results suggest that patients with Ki-67-positive biopsies remaining in AS for >1 year have an increased risk for PCa progression and conversion to treatment. Studies to further confirm Ki-67 as a marker for risk stratification, especially with a positivity cut-off of 5%, are warranted in larger cohorts of AS patients. Full article
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ALK Expression Without ALK Rearrangement in EWSR1::ATF1-Fused Inflammatory and Nested Testicular Sex Cord Tumor
by Min Chong Kim, Hee Jung Kwon and Su Hong Kim
Diagnostics 2026, 16(17), 2847; https://doi.org/10.3390/diagnostics16172847 - 4 Sep 2026
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Abstract
Inflammatory and nested testicular sex cord tumor (IN-TSCT) is a recently recognized, rare testicular sex cord–stromal neoplasm characterized by a recurrent EWSR1::ATF1 fusion and potentially aggressive clinical behavior. Because of its nested epithelioid morphology accompanied by prominent inflammatory infiltrates, IN-TSCT may be mistaken [...] Read more.
Inflammatory and nested testicular sex cord tumor (IN-TSCT) is a recently recognized, rare testicular sex cord–stromal neoplasm characterized by a recurrent EWSR1::ATF1 fusion and potentially aggressive clinical behavior. Because of its nested epithelioid morphology accompanied by prominent inflammatory infiltrates, IN-TSCT may be mistaken for seminoma, while frequent diffuse CD30 expression further complicates the differential diagnosis with lymphoma. We report a case of IN-TSCT in a 54-year-old man presenting with intermittent left testicular pain. Scrotal ultrasonography demonstrated a well-defined, heterogeneously hypoechoic intratesticular mass with minimally increased internal vascularity. Radical orchiectomy revealed a 1.5 × 1.4 cm epithelioid neoplasm arranged in nests and cords with a prominent inflammatory infiltrate. The tumor cells expressed the sex cord–stromal markers SF-1 and calretinin and showed diffuse CD30 expression. RNA-based next-generation sequencing identified an EWSR1::ATF1 fusion, establishing the diagnosis of IN-TSCT. Unexpectedly, the tumor also demonstrated strong ALK immunoreactivity with both the ALK1 and D5F3 antibody clones, despite the absence of an ALK fusion by RNA sequencing or an ALK rearrangement by fluorescence in situ hybridization. The combined expression of CD30 and ALK may mimic anaplastic large cell lymphoma and represents an important diagnostic pitfall. The patient remained free of recurrence or metastasis 18 months after orchiectomy. This case expands the recognized immunophenotypic spectrum of IN-TSCT and demonstrates that strong ALK immunoreactivity does not necessarily indicate an underlying ALK fusion or rearrangement. Given the potentially aggressive clinical behavior reported in IN-TSCT, long-term oncologic surveillance is warranted. Full article
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