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Life
Special Issues
Diagnosis, Treatment and Prognosis of Prostate Cancer
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Diagnosis, Treatment and Prognosis of Prostate Cancer

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (25 February 2026) | Viewed by 9120

Editors

Dr. Juan Gómez Rivas

E-Mail Website
Guest Editor
1. Department of Urology, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, 28040 Madrid, Spain
2. Department of Urology, Universidad Complutense de Madrid, 28015 Madrid, Spain
Interests: urological oncology; laparoscopy and robotics; kidney transplant
Special Issues, Collections and Topics in MDPI journals
Dr. Jesús Moreno Sierra

E-Mail Website
Guest Editor
1. Department of Urology, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, 28040 Madrid, Spain
2. Department of Urology, Universidad Complutense de Madrid, 28015 Madrid, Spain
Interests: urological oncology; robotics; functional urology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Prostate cancer is the most common non-skin cancer in men and the second leading cause of cancer-related deaths among men worldwide. The understanding and management of prostate cancer have evolved significantly over the past few decades. Early detection through PSA (prostate-specific antigen) testing has transformed the landscape of prostate cancer diagnosis, allowing for earlier and more effective intervention. However, challenges remain in differentiating between indolent and aggressive forms of the disease, leading to a need for more precise diagnostic tools and treatment strategies. Treatment approaches have diversified, ranging from active surveillance for low-risk cases to advanced therapies such as targeted therapy, immunotherapy, and robotic-assisted surgery for high-risk and metastatic prostate cancer. The focus on prognosis has also intensified, with ongoing research into biomarkers and genetic profiling aiming to predict disease progression more accurately and tailor treatment to individual patients.

The aim of this Special Issue is to compile the latest research and expert reviews on the diagnosis, treatment, and prognosis of prostate cancer. This issue will cover a wide range of topics, from advancements in early detection and imaging techniques to novel treatment modalities and prognostic tools that enhance the ability to predict outcomes. The scope includes developments in understanding the molecular underpinnings of prostate cancer as well as innovative approaches to managing and treating different stages of the disease, from localized to advanced metastatic prostate cancer.

This Special Issue is intended to serve as a valuable resource for clinicians, researchers, and healthcare professionals involved in the care of prostate cancer patients. It will also be of interest to policymakers and educators seeking to stay informed on the latest developments in this rapidly evolving field.

Dr. Juan Gómez Rivas
Dr. Jesús Moreno Sierra
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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly 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

  • active surveillance
  • hormonal treatment
  • personalized medicine
  • prostate cancer
  • robotic surgery
  • targeted therapy

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Published Papers (5 papers)

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Research

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19 pages, 2859 KB  
Article
Integrated Urinary and Tissue Proteomic Signatures Reveal Core and Progression Biomarkers in MRI-Visible and MRI-Non-Visible Prostate Cancer
by Ana Blanca, Ana C. Morillo, Antonio Lopez-Beltran, Guillermo Lendinez Cano, Rafael A. Medina, Laura Chamorro Castillo, Daniel López Ruiz, Eduardo Chicano-Galvez, Juan Pablo Campos Hernández and Enrique Gómez Gómez
Life 2026, 16(3), 383; https://doi.org/10.3390/life16030383 - 27 Feb 2026
Viewed by 972
Abstract
Background: Prostate cancer (PCa) shows a marked biological heterogeneity that is closely associated with tumor aggressiveness. A substantial proportion of clinically significant tumors remain undetected by multiparametric magnetic resonance imaging (mpMRI). Elucidating the molecular basis of MRI visibility and identifying non-invasive biomarkers could [...] Read more.
Background: Prostate cancer (PCa) shows a marked biological heterogeneity that is closely associated with tumor aggressiveness. A substantial proportion of clinically significant tumors remain undetected by multiparametric magnetic resonance imaging (mpMRI). Elucidating the molecular basis of MRI visibility and identifying non-invasive biomarkers could improve the risk stratification and clinical management of patients. Accordingly, this study aimed to assess tissue and urine proteomic signatures associated with PCa aggressiveness and mpMRI visibility. Methods: In this exploratory study, we performed an integrated proteomic analysis of prostate tissue and preoperative urine samples from 24 patients stratified into four groups: benign prostatic hyperplasia (BPH), indolent PCa (Gleason 6), clinically significant PCa with MRI-visible lesions, and clinically significant PCa with MRI-non-visible lesions. Data-independent acquisition mass spectrometry (DIA workflows) was used to identify differentially expressed proteins associated with malignancy, tumor aggressiveness, and MRI visibility. Results: Pairwise proteomic analyses revealed significant molecular differences between BPH and all PCa groups, identifying 694 non-redundant proteins differentially expressed in tissue and 482 in preoperative urine, showing molecular features associated with both disease presence and progression. Comparative tissue and urine analyses identified 82 proteins, reflecting shared biological pathways in metabolism, cytoskeletal organization, immune processes, and extracellular matrix remodeling. Finally, a direct comparison of MRI-visible and MRI-non-visible clinically significant PCa identified a panel of differentially expressed proteins, including LCN2/NGAL, S100A9, and AOC1/DAO, that showed differential urinary abundance and prognostic relevance in the TCGA-PRAD cohort. Conclusions: Our results suggest that proteomic alterations in PCa are associated with disease progression and aggressiveness and capture biologically relevant differences between tissue and urinary proteomes. These differences are also observed between MRI-visible and MRI-non-visible clinically significant prostate cancers, supporting the potential of urinary proteomics as a non-invasive complement to imaging-based diagnostics. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Prostate Cancer)
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12 pages, 817 KB  
Article
CT-Based Quantification of Prostate Volume Change After LHRH-Agonist Androgen Deprivation: A Prospective, Three-Reader Study for Radiotherapy Planning
by Nicolás Feltes Benítez, Manuel Galdeano-Rubio, Jesus Muñoz-Rodriguez, Arturo Domínguez, Josep Maria Solé i Monné, Meritxell Pérez Márquez, Sergio Caballero del Pozo, Inma Díaz-Álvarez, Felipe Couñago and Saturio Paredes-Rubio
Life 2026, 16(1), 29; https://doi.org/10.3390/life16010029 - 25 Dec 2025
Cited by 1 | Viewed by 1035
Abstract
Introduction: ADT is routinely combined with radiotherapy (RT) for intermediate- and high-risk prostate cancer. While prostate shrinkage may facilitate planning, prospective CT-based, patient-level estimates over short, workflow-relevant intervals are scarce. Methods: We conducted a prospective study of 47 patients starting luteinizing hormone-releasing hormone [...] Read more.
Introduction: ADT is routinely combined with radiotherapy (RT) for intermediate- and high-risk prostate cancer. While prostate shrinkage may facilitate planning, prospective CT-based, patient-level estimates over short, workflow-relevant intervals are scarce. Methods: We conducted a prospective study of 47 patients starting luteinizing hormone-releasing hormone agonist (LHRHa) therapy (leuprolide, 6-month depot). Prostate volumes were independently contoured by three blinded radiation oncologists on paired CT scans at baseline and ~8 weeks post-injection. The primary outcomes were the mean relative volume change and the proportion achieving a clinically relevant reduction (≥15%). PSA and testosterone were recorded at both time points; correlations and exploratory univariable logistic regression for ≥15% reduction were performed at the patient level. Results: Mean relative volume reduction ranged from −18.5% to −21.3% across observers; ≥60% of patients met the ≥15% threshold (RT-A 61.7%, RT-B 66.0%, RT-C 74.5%). PSA and testosterone decreased substantially (e.g., median PSA from 9.64 to 1.84 nmol/L) and were moderately correlated (Spearman ρ = 0.43, p = 0.002; Pearson r = 0.51, p < 0.001). No baseline clinical, histologic, or biochemical variables reached statistical significance for predicting ≥15% volume reduction; % PSA change showed a non-significant trend (OR 1.03; 95% CI 1.00–1.07; p = 0.076). Conclusions: Short-course LHRHa induced consistent CT-measured cytoreduction, with more than half of cases achieving ≥15% shrinkage within 8 weeks. Prostate downsizing was reproducible across readers and accompanied by marked PSA and testosterone declines, although biochemical responses did not predict volumetric change. These findings support incorporating a short neoadjuvant “window” before RT simulation and highlight the need for larger studies to refine predictors and compare agonist vs. antagonist trajectories. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Prostate Cancer)
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Review

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16 pages, 287 KB  
Review
The Role of SBRT in Oligometastatic Prostate Cancer: Where We Are and Where We Are Heading
by Macarena Teja, Miguel Angel Berenguer Frances, Fernando López Campos, Nicolas Feltes Benítez, Alexandra Stoica, Andrea Puertas, Giulia Marvaso, Vedang Murthy and Felipe Couñago
Life 2026, 16(4), 550; https://doi.org/10.3390/life16040550 - 26 Mar 2026
Viewed by 1919
Abstract
Oligometastatic prostate cancer represents a distinct biological state between localized and widely metastatic disease, characterized by a limited number of lesions. Stereotactic body radiotherapy (SBRT) has emerged as a key metastasis-directed therapy (MDT), enabling precise ablation of metastatic lesions with minimal toxicity. Prospective [...] Read more.
Oligometastatic prostate cancer represents a distinct biological state between localized and widely metastatic disease, characterized by a limited number of lesions. Stereotactic body radiotherapy (SBRT) has emerged as a key metastasis-directed therapy (MDT), enabling precise ablation of metastatic lesions with minimal toxicity. Prospective clinical trials such as SABR-COMET, STOMP, ORIOLE, RADIOSA, and EXTEND have shown that SBRT delays disease progression, prolongs progression-free survival, and postpones the need for systemic therapy, while maintaining a favorable safety profile. Nevertheless, methodological limitations persist, including heterogeneity in defining oligometastatic disease, variability in dosing and fractionation, and the lack of predictive biomarkers. Ongoing phase III trials aim to validate the integration of SBRT with modern systemic therapies, including next-generation androgen receptor pathway inhibitors, to optimize clinical outcomes in hormone-sensitive and castration-resistant oligometastatic prostate cancer. This review summarizes current evidence, clinical applications, and future directions for SBRT in this patient population. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Prostate Cancer)
12 pages, 1113 KB  
Review
Beyond PSA: The Future of Prostate Cancer Diagnosis Using Artificial Intelligence, Novel Biomarkers, and Advanced Imagery
by Moncef Al Barajraji, Mathieu Coscarella, Ilyas Svistakov, Helena Flôres Soares da Silva, Paula Mata Déniz, María Jesús Marugan, Claudia González-Santander, Lorena Fernández Montarroso, Isabel Galante, Juan Gómez Rivas and Jesús Moreno Sierra
Life 2025, 15(10), 1508; https://doi.org/10.3390/life15101508 - 25 Sep 2025
Cited by 4 | Viewed by 3392
Abstract
Prostate cancer (PCa) diagnosis has historically relied on the prostate-specific antigen (PSA) testing. Although the screening significantly reduces mortality rates, PSA has low specificity with risks of overdiagnosis and overtreatment. These limitations highlight the need for a more accurate diagnostic approach. Emerging technologies, [...] Read more.
Prostate cancer (PCa) diagnosis has historically relied on the prostate-specific antigen (PSA) testing. Although the screening significantly reduces mortality rates, PSA has low specificity with risks of overdiagnosis and overtreatment. These limitations highlight the need for a more accurate diagnostic approach. Emerging technologies, such as artificial intelligence (AI), novel biomarkers, and advanced imaging techniques, offer promising avenues to enhance the accuracy and efficiency of PCa diagnosis and risk stratification. This narrative review comprehensively analyzed the current literature, focusing on new tools aiding PCa diagnosis (AI-driven image interpretation, radiomics, genomic classifiers, biomarkers, and multimodal data integration) with consideration for technical, regulatory, and ethical challenges related to clinical implementation of AI-based technologies. A literature search was performed using the PubMed and MEDLINE databases to identify relevant peer-reviewed articles published in English using the search terms “prostate cancer,” “artificial intelligence,” “machine learning,” “deep learning,” “MRI,” “histopathology,” and “diagnosis.” Articles were selected based on their relevance to AI-assisted diagnostic tools, clinical utility, and performance metrics. In addition, a separate section was developed initially to contextualize the limitations of current PSA-based screening approaches. The reviewed studies showed that AI had significant utility in prostate mpMRI interpretation (lesion detection; Gleason grading) with high accuracy and high reproducibility. For the pathologist, AI-driven algorithms improve the diagnostic accuracy of digital slide evaluation for histologic diagnosis of prostate cancer and automated Gleason score grading. Genomic tools such as the Oncotype DX test, combined with AI, could also allow for tailored and individualized risk prediction. Overall, multimodal models integrating clinical, imaging, and molecular data often outperform traditional PSA-based strategies and reduce unnecessary biopsies. Transition from PSA-centered toward AI-driven, biomarker-supported, and image-enhanced diagnosis marks a critical evolution in PCa diagnosis. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Prostate Cancer)
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Other

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7 pages, 666 KB  
Case Report
Robot-Assisted Radical Prostatectomy After Rezūm: A Case Report and Literature Review
by Kosta Cerović and Simon Hawlina
Life 2026, 16(2), 362; https://doi.org/10.3390/life16020362 - 21 Feb 2026
Viewed by 891
Abstract
Minimally invasive surgical therapies (MISTs), such as Rezūm™ Water Vapor Therapy, are emerging treatment options for benign prostatic obstruction (BPO). When prostate cancer is subsequently diagnosed, radical prostatectomy may still be indicated. However, evidence regarding intraoperative challenges and the surgical and functional outcomes [...] Read more.
Minimally invasive surgical therapies (MISTs), such as Rezūm™ Water Vapor Therapy, are emerging treatment options for benign prostatic obstruction (BPO). When prostate cancer is subsequently diagnosed, radical prostatectomy may still be indicated. However, evidence regarding intraoperative challenges and the surgical and functional outcomes of robot-assisted radical prostatectomy (RARP) following Rezūm remains limited. We report the first documented case of RARP following Rezūm in a 68-year-old man. He initially underwent Rezūm for symptomatic BPO. Due to rising PSA, a suspicious lesion on MRI, and a biopsy-confirmed high-risk prostate carcinoma, radical surgery was performed. Intraoperatively, dense fibrosis and altered tissue planes required precise dissection and a level 2 bilateral nerve-sparing approach. A systematic review revealed no previously published cases of RARP after Rezūm. On the other hand, RARP after transurethral resection of the prostate (TURP) is associated with increased operative time, blood loss, and bladder neck reconstruction, though late continence and biochemical recurrence rates are similar to those in treatment-naïve patients. In conclusion, RARP after ablative BPO therapies is feasible but may present unique technical challenges. Larger prospective studies are needed to develop standardized management strategies. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Prostate Cancer)
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