Submit to JCM Review for JCM Propose a Special Issue

Journal Menu

Journal Browser

Prostate Cancer: Diagnosis, Clinical Management and Prognosis

Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

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

Deadline for manuscript submissions: closed (20 May 2026) | Viewed by 6654

Share This Special Issue

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 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. 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

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (6 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

10 pages, 651 KB

Open AccessArticle

Learning Curve of Docking Time in Robot-Assisted Radical Prostatectomy with the Hugo RAS System: How Many Procedures to Achieve Efficiency?

by Andrea Iannuzzi, Alberto Ragusa, Alessandro De Giuseppe, Francesco Prata, Francesco Tedesco, Benito Fabio Mirto, Fabio Machiella, Gianluca Muto, Donato Dente, Giovanni Muto and Rocco Papalia

J. Clin. Med. 2026, 15(9), 3509; https://doi.org/10.3390/jcm15093509 - 4 May 2026

Viewed by 503

Abstract

Objectives: Recently, the Hugo RAS System has been introduced on the market and features a modular design comprising four separate, independent arm carts. In this study we aim to identify the number of consecutive robotic-assisted radical prostatectomies (RARP) required to achieve optimal docking time with this new robotic platform. Methods: Data from 68 patients who underwent RARP with the New Hugo RAS System were analyzed. A three-arm setting was used in every case. The docking was executed by the same urology resident who had successfully completed the training course as a bed assistant provided by Medtronic at the ORSI Academy in Aalst, Belgium. Statistical analysis included univariate linear regression to evaluate the association between the number of consecutive procedures (independent variable) and docking time (dependent variable). Additionally, a cumulative sum (CUSUM) analysis was conducted to assess the learning curve, identifying the point at which docking time stabilized. Results: The analysis included 68 patients. The median “skin to skin” operative time was 198 min (IQR 90–375), with a total console time median of 150 min (IQR 60–335) and a docking time median of 5 min (IQR 4–13). Linear regression analysis showed a significant negative correlation between the number of procedures performed and docking time (p < 0.0017), indicating that increased experience correlates with reduced docking time. CUSUM analysis revealed that after the sixth procedure, docking time consistently declined, suggesting that the learning curve for achieving optimal docking time was reached around this point. Conclusions: These findings suggest that, despite being a new platform with four independent arms, the Hugo RAS System allows for a brief docking time to be achieved with just a few procedures, thus not impacting the overall duration of the surgical procedure. Full article

(This article belongs to the Special Issue Prostate Cancer: Diagnosis, Clinical Management and Prognosis)

► Show Figures

Figure 1

18 pages, 8745 KB

Open AccessArticle

Automated Prostate Cancer Detection on T2-Weighted MRI Using a Dual-Stream Attention Network: A Study on Private Saudi Clinical Data and Public Benchmark Datasets

by Saeed Alqahtani, M. A. Jowhari, Yahya.Q. Sabi and Hussein Alshaari

J. Clin. Med. 2026, 15(9), 3327; https://doi.org/10.3390/jcm15093327 - 27 Apr 2026

Viewed by 356

Abstract

Background: The steady rise of prostate cancer in Saudi Arabia signals a critical public health shift that requires immediate investment in early detection and prevention to mitigate a future clinical crisis. Accurate diagnosis using multiparametric MRI and PI-RADS scoring remains challenging, as interpretations are highly experience-dependent and subspecialized radiologists are limited. Methods: To address this gap, this study introduces a novel Dual-Stream Attention Network designed to automate the classification of low-risk (PIRADS 2-3) versus high-risk (PIRADS 4-5) lesions from T2-weighted MRI. Leveraging a ResNet50 backbone, the architecture employs parallel streams for Local and Global Feature Processing, each enhanced by a Channel-Spatial Attention module to highlight diagnostically relevant regions. These features are integrated through a Cross-Stream Fusion mechanism and a gate-controlled Adaptive Feature Fusion module to optimize multi-scale information. The model was developed and validated on a regional dataset of 3850 images from Jazan Specialist Hospital and Prince Mohammed bin Naser Hospital. This research provides a standardized, high-precision diagnostic path tailored to the Saudi Arabian population, conducted under institutional review board approval (No. 25138). Results: The proposed dual-stream attention network achieved an accuracy of 97.8% on the validation set and 96.4% on the test set, demonstrating high performance and generalization capabilities in classifying prostate lesions from Saudi patient populations. Conclusions: The proposed dual-stream architecture with novel attention and fusion mechanisms demonstrates high effectiveness for prostate cancer classification from T2-weighted MRI in Saudi clinical settings. This represents the first deep learning model specifically trained and validated on Saudi Arabian prostate MRI data, with the potential to address the shortage of specialized expertise and improve diagnostic efficiency in the Kingdom. Full article

(This article belongs to the Special Issue Prostate Cancer: Diagnosis, Clinical Management and Prognosis)

► Show Figures

Figure 1

10 pages, 2904 KB

Open AccessArticle

Cribriform Tumor Burden in Grade Group 4 Prostate Cancer: A Quantitative Threshold Predicting Lymphovascular Invasion and Metastasis

by Ilkay Tosun, Onur Sahin and Eyup Veli Kucuk

J. Clin. Med. 2026, 15(6), 2303; https://doi.org/10.3390/jcm15062303 - 18 Mar 2026

Viewed by 424

Abstract

Background/Objectives: Although the presence and diameter of the cribriform pattern (CP) are established prognostic factors in prostate cancer (PCa), the clinical impact of quantitative cribriform tumor burden (CTB) remains poorly characterized. This study aimed to evaluate the association between CTB and clinicopathological outcomes in Grade Group 4 PCa with large cribriform morphology (LC-GG4). Methods: We retrospectively analyzed patients with pure GG4 prostate cancer exhibiting ≥1 large cribriform gland (>0.25 mm) at radical prostatectomy. CTB was assessed as the percentage of cribriform architecture relative to the total tumor area. Following clinicopathological correlation, receiver operating characteristic (ROC) analysis determined the optimal CTB threshold for predicting lymphovascular invasion (LVI). Distant Metastasis-free survival (dMFS) and biochemical recurrence-free survival (BCRFS) were evaluated using the Kaplan–Meier and log-rank tests. Results: In 43 patients with LC-GG4, extraprostatic extension was present in 100% of cases. The median CTB was 30.0% (IQR: 15.0–60.0%). A CTB threshold of ≥25% was optimally associated with LVI (area under the curve [AUC]: 0.801, p = 0.002). High-CTB (≥25%) was strongly correlated with LVI (p = 0.002) and intraductal carcinoma (p = 0.004) and was independently associated with LVI in multivariate analysis (OR: 1.054; p = 0.006). Furthermore, high-CTB patients demonstrated significantly shorter mean dMFS (84.9 vs. 113.1 months; p = 0.042), with no significant difference observed for BCRFS. Conclusions: In LC-GG4 prostate cancer, CTB is a critical determinant of clinical aggressiveness. A quantitative threshold of ≥25% was independently associated with LVI and early metastatic progression. Quantifying CTB, rather than relying on simple binary assessment, provides superior risk stratification. Full article

(This article belongs to the Special Issue Prostate Cancer: Diagnosis, Clinical Management and Prognosis)

► Show Figures

Figure 1

12 pages, 1515 KB

Open AccessArticle

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

Cited by 1 | Viewed by 1191

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 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)

► Show Figures

Figure 1

11 pages, 1948 KB

Open AccessArticle

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

Cited by 2 | Viewed by 1473

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 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)

► Show Figures

Figure 1

13 pages, 1799 KB

Open AccessArticle

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

Cited by 1 | Viewed by 1918

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 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)

► Show Figures

Journal Menu

Journal Browser

Prostate Cancer: Diagnosis, Clinical Management and Prognosis

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (6 papers)

Research

Further Information

Guidelines

MDPI Initiatives

Follow MDPI