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Urologic Oncology: From Diagnosis to Treatment
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Urologic Oncology: From Diagnosis to Treatment

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 (15 April 2026) | Viewed by 1177

Special Issue Editors

Dr. Matteo Vittori

E-Mail Website
Guest Editor
Robotic and Minimally Invasive Urology Unit, Tor Vergata Hospital, Rome, Italy
Interests: prostate cancer; kidney cancer; bladder cancer; testicular cancer; benign prostatic hyperplasia
Dr. Valerio Iacovelli

E-Mail Website
Guest Editor
Robotic and Minimally Invasive Urology Unit, Tor Vergata Hospital, Rome, Italy
Interests: prostate cancer; kidney cancer; bladder cancer; testicular cancer; renal stones; benign prostatic hyperplasia (BPH)

Special Issue Information

Dear Colleagues,

Advances in diagnostic imaging, molecular and genomic profiling, and minimally invasive techniques have significantly enhanced our ability to detect, characterize, and treat genitourinary malignancies. Cancers of the prostate, bladder, kidney, and testis—which once relied on limited diagnostic and therapeutic strategies—are now managed with precision-based approaches, improving both oncological control and quality of life. Robotic-assisted surgery and advanced ablative technologies are redefining surgical standards, while immunotherapy and targeted agents are transforming systemic treatment paradigms. These developments have broadened therapeutic options, enabling tailored strategies for individual patients. However, they also present new challenges regarding optimal patient selection, long-term outcomes, and integration into clinical practice. In this Special Issue, we invite contributions encompassing original studies, clinical series, and review articles that highlight innovations in diagnostics, surgical techniques, systemic therapies, and the multidisciplinary management of urological cancers. Our aim is to provide a comprehensive overview of the evolving field of urological oncology and to stimulate a discussion on how these advances can best be translated into everyday practice.

Dr. Matteo Vittori
Dr. Valerio Iacovelli
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 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
  • kidney cancer
  • bladder cancer
  • testicular cancer

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Published Papers (3 papers)

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Research

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13 pages, 880 KB  
Article
Underestimation of Prostate Cancer Grade in Transperineal Fusion Biopsy and Its Predictive Factors: Correlation of Biopsy Findings with Post-Da Vinci Radical Prostatectomy Specimens
by Hubert Andrzej Krzepkowski, Tomasz Ząbkowski, Maciej Walędziak, Tomasz Waldemar Kamiński, Hubert Dąbrowski and Tomasz Syryło
J. Clin. Med. 2026, 15(7), 2780; https://doi.org/10.3390/jcm15072780 - 7 Apr 2026
Viewed by 271
Abstract
Background/Objectives: An accurate preoperative assessment of prostate cancer malignancy is crucial for risk stratification and selection of the optimal treatment strategy. This study assessed the concordance of Gleason scores between MRI–TRUS fusion biopsy and radical prostatectomy specimens, and identified clinical and histopathological [...] Read more.
Background/Objectives: An accurate preoperative assessment of prostate cancer malignancy is crucial for risk stratification and selection of the optimal treatment strategy. This study assessed the concordance of Gleason scores between MRI–TRUS fusion biopsy and radical prostatectomy specimens, and identified clinical and histopathological factors associated with post-procedural Gleason score upgrading. Methods: This retrospective analysis involved patients who underwent transperineal MRI–TRUS fusion biopsy followed by radical prostatectomy from 2020 to 2025. Concordance, upgrading, and downgrading of the Gleason score were assessed by comparing biopsy results with the final histopathological examination. Clinical parameters (age, PSA level, prostate volume, and PSA density) and histopathological features of biopsies (Gleason score and percentage of prostate lobes affected by cancer) were analyzed. Multivariate logistic regression models were stratified by PSA level (<10 ng/mL and >10 ng/mL). Results: Gleason score concordance was found in 53.1% of the 603 patients analyzed, upgrading in 29.9%, and downgrading in 17.1%. Higher Gleason scores on biopsy were independently associated with a lower risk of upgrading in the entire cohort and in both PSA subgroups. Larger tumor extent on biopsy was associated with a lower risk of upgrading, with heterogeneous dependencies between prostate lobes. The other clinical parameters showed no independent association with upgrading. Conclusions: Gleason score upgrading remains common after radical prostatectomy. The risk of this progression is primarily related to the histopathological features of the biopsy rather than to baseline clinical parameters, reflecting the limitations of biopsy as a sampling method and the biological heterogeneity of prostate cancer. Full article
(This article belongs to the Special Issue Urologic Oncology: From Diagnosis to Treatment)
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9 pages, 212 KB  
Article
Evaluation of the Approach to Rectal Injuries During Pelvic Uro-Oncological Surgery
by Ata Özen, Süleyman Öner, Necdet Fatih Yaşar, Utku Bekyürek and İyimser Üre
J. Clin. Med. 2026, 15(3), 1080; https://doi.org/10.3390/jcm15031080 - 29 Jan 2026
Viewed by 492
Abstract
Background/Objectives: Rectal injuries are rare but serious complications during pelvic surgeries. This study aimed to share our experience with primary repair of rectal injuries occurring during pelvic uro-oncological surgeries. Methods: A total of 494 patients who presented to our clinic with [...] Read more.
Background/Objectives: Rectal injuries are rare but serious complications during pelvic surgeries. This study aimed to share our experience with primary repair of rectal injuries occurring during pelvic uro-oncological surgeries. Methods: A total of 494 patients who presented to our clinic with diagnoses of non-metastatic bladder tumors and prostate cancer and underwent radical prostatectomy, and 214 patients who underwent radical cystectomy between 2010 and 2024 were included in the study. Data from 15 patients who experienced rectal injury during pelvic uro-oncological surgery were retrospectively reviewed. Patients scheduled for radical prostatectomy received rectal enemas twice a day (morning and evening) the day before surgery. Patients scheduled for radical cystectomy received a liquid diet for three days preoperatively, along with rectal enemas morning and evening. Results: Rectal injury occurred in 7 (1.4%) patients during radical prostatectomy and in 8 (3.7%) patients during radical cystectomy. All rectal injuries were detected intraoperatively. The defect was closed in two layers: muscular and serosal. Patients had no active complaints during follow-up, and no rectourinary fistula was observed. Conclusions: Intraoperative detection of rectal injury during pelvic uro-oncological surgery and high-quality primary repair of the defect play a critical role in preventing morbidity and mortality associated with rectal injury. Preoperative mechanical bowel preparation reduces contamination of the procedure, improves the visibility of the defect, and allows for high-quality primary repair. Full article
(This article belongs to the Special Issue Urologic Oncology: From Diagnosis to Treatment)

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20 pages, 667 KB  
Systematic Review
Lifestyle Interventions in Patients in Active Surveillance for Prostate Cancer: A Systematic Review
by Marco Campetella, Francesco Pio Bizzarri, Pierluigi Russo, Riccardo Bientinesi, Giovanni Battista Filomena, Maria Chiara Sighinolfi, Bernardo Rocco and Emilio Sacco
J. Clin. Med. 2026, 15(9), 3369; https://doi.org/10.3390/jcm15093369 - 28 Apr 2026
Viewed by 48
Abstract
Background/Objectives: Active surveillance (AS) has become the gold standard for managing men diagnosed with low-risk or favorable intermediate-risk prostate cancer. However, both patients and healthcare providers often face a lack of clear, evidence-based guidance regarding lifestyle choices during this period. This systematic [...] Read more.
Background/Objectives: Active surveillance (AS) has become the gold standard for managing men diagnosed with low-risk or favorable intermediate-risk prostate cancer. However, both patients and healthcare providers often face a lack of clear, evidence-based guidance regarding lifestyle choices during this period. This systematic review was designed to determine whether specific lifestyle modifications—including dietary changes, physical activity, weight control, and use of supplements—can tangibly impact oncologic outcomes or improve patient-reported quality of life during surveillance. Methods: The research followed PRISMA protocols, searching PubMed, Cochrane, and Scopus for studies published between 2000 and 2025. The team included diverse methodologies, from randomized controlled trials to qualitative interviews, specifically focusing on men on AS. To ensure high standards, two independent reviewers performed data extraction and quality assessments using CASP tools, and the review was formally registered with PROSPERO. Results: The review synthesized data from over 30 heterogeneous studies. The findings suggest that lifestyle interventions are safe and highly feasible. Physical exercise emerged as the most effective intervention, consistently improving cardiorespiratory fitness and reducing psychological burdens such as fatigue and “PSA anxiety.” While dietary changes and weight loss successfully improved metabolic health markers, they did not show a consistent ability to prevent biopsy upgrading or MRI progression. Similarly, supplements showed only minor, short-term effects on PSA kinetics without providing reproducible oncologic protection. Conclusions: For men undergoing active surveillance, lifestyle interventions may be considered as supportive measures, as they appear feasible and may improve physical fitness, metabolic health, and selected patient-reported outcomes. However, current evidence remains insufficient to demonstrate a consistent effect on biopsy upgrading, MRI progression, or long-term deferral of definitive treatment. Full article
(This article belongs to the Special Issue Urologic Oncology: From Diagnosis to Treatment)
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