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Prostate Cancer: Diagnosis, Clinical Management and Prognosis
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Prostate Cancer: Diagnosis, Clinical Management and Prognosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 1458

Special Issue Editor

Prof. Dr. Giovanni Muto

E-Mail Website
Guest Editor
Department of Urology, GVM, Maria Pia Hospital, 10132 Turin, Italy
Interests: prostate cancer; renal cancer; bladder cancer; reconstructive surgery; robotic surgery; open surgery; urinary diver-sion; minimally invasive surgery; thulium laser

Special Issue Information

Dear Colleagues,

The prevalence of prostate cancer (PCa) in Western countries is notably high, increasing with age and making it the second most diagnosed cancer in men. In 2020, approximately 1.4 million new cases and 375,000 deaths were recorded worldwide. In Europe, PCa is the most frequently diagnosed cancer in men and ranks as the third leading cause of cancer-related deaths.

Clinical decision-making and diagnosis for PCa rely on physical examinations, PSA levels, and histopathological evaluations. The highest incidence rates are observed in developed countries, primarily due to increased awareness and the widespread availability of prostate-specific antigen (PSA) screening. While the effectiveness of PSA screening remains a topic of debate, PCa continues to pose a significant public health concern, placing a considerable economic burden on society.

New treatments and therapies for PCa have been developed, with many others currently under evaluation in preclinical and clinical trials. Despite advancements in understanding and managing prostate cancer, knowledge gaps persist.

This Special Issue aims to contribute to the growing body of literature by publishing emerging data, expert opinions, and reviews. It welcomes a broad range of studies related to prostate cancer, encompassing areas such as diagnosis, clinical management, treatment, and prognosis. We encourage the submission of original research, systematic reviews, and meta-analyses.

Thank you for your collaboration.

Prof. Dr. Giovanni Muto
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 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. Journal of Clinical Medicine 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

  • prostate cancer
  • diagnosis
  • clinical management
  • prognosis
  • treatments

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Published Papers (3 papers)

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Research

12 pages, 1515 KiB  
Article
Development of a Risk Model to Identify and Prevent Factors Influencing Erectile Dysfunction After Robotic Radical Prostatectomy
by Hakan Karaca, Resul Sobay, Metin Mod, Ahmet Tahra, Hasan Samet Güngör, Abdurrahman İnkaya and Eyüp Veli Küçük
J. Clin. Med. 2025, 14(14), 4903; https://doi.org/10.3390/jcm14144903 - 10 Jul 2025
Viewed by 299
Abstract
Background/Objectives: Prostate cancer ranks as the second-most prevalent cancer globally, and is the fifth-ranking cause of cancer-related mortality. Radical prostatectomy presents a significant risk of postoperative sequelae, including erectile dysfunction. Postoperative erectile dysfunction adversely affects the patient’s quality of life and can severely [...] Read more.
Background/Objectives: Prostate cancer ranks as the second-most prevalent cancer globally, and is the fifth-ranking cause of cancer-related mortality. Radical prostatectomy presents a significant risk of postoperative sequelae, including erectile dysfunction. Postoperative erectile dysfunction adversely affects the patient’s quality of life and can severely impact total treatment satisfaction. Nomograms have demonstrated efficacy in forecasting diverse outcomes in urology. We sought to create a nomogram to facilitate a more precise, evidence-based, and individualized prediction of erectile function outcomes following radical prostatectomy. Between January 2018 and January 2022, one hundred and eleven prostate cancer patients had robot-assisted radical prostatectomy, excluding those who had undergone prior transurethral prostatectomy, radiotherapy, or hormone therapy. Demographics, medical records, preoperative and postoperative erectile function statuses, and IIEF scores (≥17 indicating retained erections, <17 indicating full erectile dysfunction) were evaluated. Outcomes: Patients’ ages ranged from 45 to 76 years, with an average of 61.18 ± 6.72 years. Patients in the emergency department were considerably older (p = 0.004; p < 0.01) and exhibited elevated Charlson Comorbidity Indices (3.63 ± 0.85; p = 0.004; p < 0.01). Preoperative IIEF scores in ED patients were lower (14.29 ± 5.34), although obturator internus thickness (20.61 ± 2.91) and intraprostatic urethra length (36.48 ± 9.3) were considerably elevated. Altered surgical techniques were linked to maintained erections (p = 0.002; p < 0.01), but traditional approaches were connected with erectile dysfunction (p = 0.007; p < 0.01). Bilateral nerve-sparing procedures were more prevalent among patients preserving erectile function (p = 0.003; p < 0.01). Conclusions: The nomogram, which includes age, Charlson Comorbidity Index, preoperative IIEF, obturator internus thickness, intraprostatic urethra length, surgical technique, and degree of nerve preservation, provides clinicians with a pragmatic instrument for forecasting postoperative erectile dysfunction in prostate cancer patients. Full article
(This article belongs to the Special Issue Prostate Cancer: Diagnosis, Clinical Management and Prognosis)
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11 pages, 1948 KiB  
Article
Factors Determining Postoperative Early Continence in Patients Undergoing Robotic Radical Prostatectomy
by Metin Mod, Hasan Samet Güngör, Hakan Karaca, Ahmet Tahra, Resul Sobay, Abdurrahman İnkaya and Eyüp Veli Küçük
J. Clin. Med. 2025, 14(13), 4405; https://doi.org/10.3390/jcm14134405 - 20 Jun 2025
Viewed by 367
Abstract
Background/Objectives: Prostate cancer is the second most common malignancy in men, and robot-assisted radical prostatectomy (RARP) has become a preferred treatment for localized disease. Postoperative urinary continence is a key determinant of quality of life. The aim of this study was to [...] Read more.
Background/Objectives: Prostate cancer is the second most common malignancy in men, and robot-assisted radical prostatectomy (RARP) has become a preferred treatment for localized disease. Postoperative urinary continence is a key determinant of quality of life. The aim of this study was to evaluate the preoperative patient characteristics and multiparametric magnetic resonance imaging (mpMRI) data that determine early postoperative continence in patients who underwent robotic radical prostatectomy at our clinic. Methods: In this study, patients who underwent robotic radical prostatectomy at our clinic between March 2020 and June 2022 were evaluated. The patients’ demographic data, preoperative PSA levels, digital rectal examination findings, preoperative lower urinary tract symptoms, sexual function, mpMRI findings, Briganti scores, surgical techniques used during the procedure and postoperative continence status were assessed. Results: A total of 111 patients were included in the study. The mean age of the patients was 61.1 years. The median follow-up duration was twelve months. According to the postoperative continence status, 22% of the patients were incontinent, 53% had moderate continence and 24% were fully continent in the first month. At the third month, 16.8% of the patients were incontinent, 31.3% had moderate continence and 51.8% were fully continent. At the one-year postoperative follow-up, the percentages of incontinent, moderately continent and fully continent patients were 4.8%, 13.2% and 81.9%, respectively. Urethral width in mpMRI (p: 0.012), pelvic transverse (p: 0.002) and AP (anterior–posterior) diameters (p: 0.033), preoperative IPSS scores (p: 0.033) and the presence of bilateral nerve-sparing surgery (p: 0.047) were found to be associated with postoperative urinary continence. No significant differences were found between groups regarding the relationship of other parameters evaluated by mpMRI with continence. Conclusions: In our study, preoperative IPSS scores, urethral width in mpMRI, pelvic transverse and AP diameters and the performance of nerve-sparing surgery were associated with early postoperative continence. Further studies with larger patient populations are needed to better understand the long-term predictors of postoperative urinary incontinence following radical prostatectomy. Full article
(This article belongs to the Special Issue Prostate Cancer: Diagnosis, Clinical Management and Prognosis)
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13 pages, 1799 KiB  
Article
Proposal for an Expanded “R” Classification: Impact of Positive Surgical Margin Length on Biochemical Recurrence After Robotic Radical Prostatectomy
by Alper Kerem Aksoy, Ahmet Tahra, Resul Sobay, Ali Kumcu, İlkay Tosun, Uğur Boylu and Eyüp Veli Küçük
J. Clin. Med. 2025, 14(12), 4310; https://doi.org/10.3390/jcm14124310 - 17 Jun 2025
Viewed by 405
Abstract
Objectives: In this study, the effect of positive surgical margin (PSM) length on predicting postoperative biochemical recurrence (BCR) after radical prostatectomy was evaluated, and based on the findings, an additional R subclassification to the TNM-R system was proposed. Methods: We retrospectively [...] Read more.
Objectives: In this study, the effect of positive surgical margin (PSM) length on predicting postoperative biochemical recurrence (BCR) after radical prostatectomy was evaluated, and based on the findings, an additional R subclassification to the TNM-R system was proposed. Methods: We retrospectively analyzed patients who underwent robot-assisted radical prostatectomy between 30 July 2008 and 31 December 2019. Only patients with PSM were included. Those with negative margins, those receiving neoadjuvant/adjuvant hormone therapy, or those with prior pelvic radiotherapy were excluded. A total of 353 pathology specimens were re-evaluated by a uropathologist, and the PSM length was quantitatively measured. BCR was defined as a PSA level of ≥0.2 ng/mL in two consecutive measurements. Results: The median follow-up time of the patients was 49.5 ± 33.4 months. BCR occurred in 27.1% (n = 96) of patients. A PSM cut-off length of 3.5 mm was identified for predicting BCR (p < 0.001). Among patients with PSM < 3.5 mm, 9.8% experienced BCR, while 54.3% of those with PSM ≥ 3.5 mm did. A PSM length ≥ 3.5 mm was associated with a higher risk of recurrence (OR: 1.249, 95% CI: 1.160–1.345, p < 0.001). In multivariate logistic regression analysis, PSM length remained an independent prognostic factor for BCR (p < 0.001). Conclusions: Quantitative measurement of PSM length serves as an independent predictor of BCR following radical prostatectomy. We propose subclassifying R1 margins into R1a (<3.5 mm) and R1b (≥3.5 mm), which may enhance prognostic accuracy in pathological reporting. Full article
(This article belongs to the Special Issue Prostate Cancer: Diagnosis, Clinical Management and Prognosis)
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