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Diagnostics
Special Issues
Current Diagnosis and Management in Urothelial Carcinomas
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Current Diagnosis and Management in Urothelial Carcinomas

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 June 2025) | Viewed by 834

Special Issue Editors

Dr. Simone Morra

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Guest Editor
1. Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
2. Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
3. ORSI Academy, Ghent, Belgium
Interests: urologic oncology; bladder cancer; kidney cancer; prostate cancer; testis cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Francesco Di Bello

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Guest Editor
1. Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
Interests: urologic oncology; bladder cancer; kidney cancer; prostate cancer; testis cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are delighted to present this Special Issue focusing on diagnostics and management in urothelial carcinomas, a subset of urologic malignancies with unique challenges and clinical implications. Urothelial carcinomas, which primarily affect the bladder but can also arise in the upper urinary tract, represent a significant burden on healthcare systems worldwide. Despite advancements in diagnostic techniques and therapeutic options, urothelial carcinomas continue to pose challenges in early detection, accurate staging and effective management.

This Special Issue aims to provide a comprehensive overview of the latest developments and innovations in the diagnosis and management of urothelial carcinomas. From emerging biomarkers and genomic profiling to advancements in imaging modalities such as multiparametric MRI and PET-CT, we seek to explore the evolving landscape of diagnostic strategies in urothelial cancer care.

We invite researchers, clinicians and experts in the field to contribute original research articles, review papers and case studies that delve into various aspects of the current diagnostics and management strategies specific to urothelial carcinomas. By consolidating insights from multidisciplinary perspectives, we aim to facilitate a deeper understanding of diagnostic challenges and opportunities in urothelial cancer management, ultimately striving toward enhanced patient outcomes and quality of care.

We look forward to receiving your contributions and shaping this Special Issue, which we envision as a pivotal resource for advancing the field of urothelial carcinoma diagnostics and management.

Dr. Simone Morra
Dr. Francesco Di Bello
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. Diagnostics 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 2600 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

  • urothelial cancer
  • emerging biomarkers
  • genomic profiling
  • imaging modalities
  • current diagnostics and management strategies

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Published Papers (2 papers)

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12 pages, 551 KiB  
Article
How Accurately Can Urologists Predict Eligible Patients for Immediate Postoperative Intravesical Chemotherapy in Bladder Cancer?
by Hüseyin Alperen Yıldız, Müslim Doğan Değer and Güven Aslan
Diagnostics 2025, 15(15), 1856; https://doi.org/10.3390/diagnostics15151856 - 23 Jul 2025
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Abstract
Background/Objectives: In non-muscle-invasive bladder cancer (NMIBC), the decision for immediate postoperative single-dose intravesical chemotherapy (SI) is based on clinical and presumed pathological features, as a definitive pathology is unknown at the time of surgery. This study aims to assess how accurately urologists can [...] Read more.
Background/Objectives: In non-muscle-invasive bladder cancer (NMIBC), the decision for immediate postoperative single-dose intravesical chemotherapy (SI) is based on clinical and presumed pathological features, as a definitive pathology is unknown at the time of surgery. This study aims to assess how accurately urologists can predict the pathological features of bladder tumors based solely on cystoscopic appearance and evaluate their ability to identify patients eligible for SI. Methods: A total of 104 patients with bladder masses were included. Seven senior urologists and four residents participated. Before transurethral resection, both groups predicted tumor stage, grade, and the presence of carcinoma in situ (CIS). Resident predictions were collected for all 104 patients, while senior predictions were collected for 72 patients. Based on these predictions, patient eligibility for SI was determined according to the EAU NMIBC guidelines. After final pathology reports, risk scores were recalculated and compared with the surgeons’ predictions. Cohen’s Kappa (κ) coefficient was used to assess agreement between predictions and pathology. Positive and negative predictive values were also calculated for both groups. Results: Strong agreement with final pathology could not be demonstrated for stage, grade, or CIS for either group. Urology residents’ predictions were slightly more accurate than those of senior urologists. Overall, 19.4% (14/72) (based on senior urologists’ predictions) and 18.2% (19/104) (based on resident predictions) of patients were misclassified and either overtreated or undertreated. Conclusions: Cystoscopic visual prediction alone is insufficient for determining eligibility for immediate postoperative intravesical chemotherapy, regardless of the urologist’s experience. More objective criteria are needed to improve the selection of appropriate patients for SI. Full article
(This article belongs to the Special Issue Current Diagnosis and Management in Urothelial Carcinomas)
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15 pages, 1048 KiB  
Article
Prognostic Value of the De Ritis Ratio in Predicting Survival After Bladder Recurrence Following Nephroureterectomy for Upper Urinary Tract Tumors
by Enis Mert Yorulmaz, Kursad Donmez, Serkan Ozcan, Osman Kose, Sacit Nuri Gorgel, Enes Candemir and Yigit Akin
Diagnostics 2025, 15(15), 1840; https://doi.org/10.3390/diagnostics15151840 - 22 Jul 2025
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Abstract
Background/Objectives: Upper tract urothelial carcinoma (UTUC) is often complicated by intravesical recurrence and cancer progression following radical nephroureterectomy (RNU). Identifying reliable prognostic biomarkers remains crucial for optimizing postoperative surveillance. The goal of this study was to assess the prognostic value of the [...] Read more.
Background/Objectives: Upper tract urothelial carcinoma (UTUC) is often complicated by intravesical recurrence and cancer progression following radical nephroureterectomy (RNU). Identifying reliable prognostic biomarkers remains crucial for optimizing postoperative surveillance. The goal of this study was to assess the prognostic value of the De Ritis ratio (AST/ALT) in predicting bladder recurrence and oncologic outcomes in patients with clinically localized UTUC undergoing RNU. Methods: This retrospective study analyzed 87 patients treated with RNU between 2018 and 2025. Preoperative De Ritis ratios were calculated, and an optimal cut-off value of 1.682 was determined using ROC analysis. Recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were analyzed using the Kaplan–Meier and Cox regression methods. Logistic regression was used to identify independent predictors of bladder recurrence. Results: A high De Ritis ratio was significantly associated with increased bladder recurrence and worse RFS and CSS, but not OS. Multivariate analysis confirmed that an elevated De Ritis ratio, current smoking, positive surgical margins, and synchronous bladder cancer were the independent predictors of bladder recurrence. The De Ritis ratio demonstrated strong discriminatory performance (AUC: 0.807), with good sensitivity and specificity for predicting recurrence. Conclusions: The De Ritis ratio is a simple, cost-effective preoperative biomarker that may aid in identifying UTUC patients at higher risk for intravesical recurrence and cancer-specific mortality. Incorporating this ratio into clinical decision-making could enhance risk stratification and guide tailored follow-up strategies. Full article
(This article belongs to the Special Issue Current Diagnosis and Management in Urothelial Carcinomas)
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