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Medicina
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Diagnosis and Treatment of Urologic Oncology
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Diagnosis and Treatment of Urologic Oncology

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Urology & Nephrology".

Deadline for manuscript submissions: 20 October 2026 | Viewed by 10286

Special Issue Editors

Dr. Juan Gómez Rivas

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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,

Urologic oncology encompasses the study, diagnosis, and treatment of cancers affecting the urinary system and male reproductive organs, including prostate, bladder, kidney, and testicular cancers. These malignancies represent a significant portion of global cancer incidence, with prostate cancer being the second most common cancer in men worldwide. The evolution of urologic oncology has seen significant advancements in both diagnostic tools, such as imaging and biomarkers, and treatment modalities, including surgery, radiation therapy, chemotherapy, and, more recently, immunotherapy and targeted therapies. Over the past few decades, research has moved from focusing solely on survival to also considering quality of life, leading to the development of less invasive treatments and personalized medicine approaches. This Special Issue will present a comprehensive collection of the latest research and reviews on the diagnosis and treatment of urologic oncology. It will cover a broad spectrum of advancements in this field, from early detection and screening strategies to novel therapeutic approaches and multidisciplinary management of advanced and metastatic urologic cancers. This Special Issue’s scope includes, but is not limited to, cutting-edge diagnostic technologies, innovative surgical techniques, targeted therapies, the role of precision medicine, and the impacts of these advancements on patient outcomes. We are soliciting a wide range of papers that contribute to our understanding and the advancement of urologic oncology. These include, but are not limited to, original research articles, review articles, and technical notes with descriptions of new surgical techniques or innovations in diagnostic technologies.

This Special Issue will serve as a valuable resource for clinicians, researchers, and healthcare professionals involved in the diagnosis and treatment of urologic cancers, as well as for policymakers and educators in the field of urological oncology.

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-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina 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 2200 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

  • bladder cancer
  • kidney cancer
  • personalized medicine
  • prostate cancer
  • robotic surgery
  • targeted therapy
  • testicular cancer

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Published Papers (6 papers)

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Research

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13 pages, 453 KB  
Article
Preoperative Gamma-Glutamyltransferase-to-Lymphocyte Ratio as an Independent Prognostic Biomarker in Patients Undergoing Radical Cystectomy for Bladder Cancer
by Tomohiro Matsuo, Shintaro Mori, Hiroyuki Honda, Shota Kakita, Kyohei Araki, Kensuke Mitsunari, Kojiro Ohba, Yasushi Mochizuki and Ryoichi Imamura
Medicina 2026, 62(2), 343; https://doi.org/10.3390/medicina62020343 - 8 Feb 2026
Viewed by 504
Abstract
Background and Objectives: Gamma-glutamyltransferase-to-lymphocyte ratio (GLR) is a prognostic biomarker reflecting oxidative stress and host immune status. However, its prognostic value in patients with bladder cancer undergoing radical cystectomy (RC) remains unclear. This study aimed to investigate whether preoperative GLR predicts survival [...] Read more.
Background and Objectives: Gamma-glutamyltransferase-to-lymphocyte ratio (GLR) is a prognostic biomarker reflecting oxidative stress and host immune status. However, its prognostic value in patients with bladder cancer undergoing radical cystectomy (RC) remains unclear. This study aimed to investigate whether preoperative GLR predicts survival outcomes following RC. Materials and Methods: We retrospectively reviewed 110 patients with urothelial carcinoma of the bladder (pure urothelial carcinoma or urothelial carcinoma with variant histology) who underwent RC at a single tertiary center between 2008 and 2022. GLR was calculated as serum gamma-glutamyltransferase (U/L) divided by absolute lymphocyte count (×109/L) using routine preoperative blood samples. Patients were categorized into low-GLR (≤17.0; n = 54) and high-GLR (>17.0; n = 56) groups based on the cohort median cut-off (17.0). Overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS) were assessed using Kaplan–Meier analysis and compared by log-rank tests. Cox proportional hazards models were used, including a preoperative model (Model 1) and a pathology-adjusted model incorporating postoperative variables (Model 2). Results: High GLR was associated with significantly worse OS, RFS, and CSS (log-rank: p = 0.020, p = 0.043, and p = 0.003, respectively). In multivariate analyses, high GLR was independently associated with inferior outcomes in both models. In Model 2, high GLR predicted worse OS (hazard ratio [HR] = 2.38; 95% confidence interval [CI] = 1.32–4.28; p = 0.003), RFS (HR = 2.37; 95% CI = 1.13–4.99; p = 0.020), and CSS (HR = 3.45; 95% CI = 1.56–8.52; p = 0.001). Conclusions: Preoperative GLR is a simple, inexpensive biomarker independently associated with survival after RC for bladder cancer, even after adjustment for established clinicopathological and pathological factors. GLR may support risk stratification and postoperative management, warranting prospective multicenter validation. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Urologic Oncology)
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14 pages, 753 KB  
Article
Perspectives on Adrenal Tumor Surgery
by Catalin Baston, Andreea Parosanu, Oana Moldoveanu, Lucas Discalicău, Pavel Visinescu, Andrei Precup and Ioanel Sinescu
Medicina 2026, 62(1), 3; https://doi.org/10.3390/medicina62010003 - 19 Dec 2025
Viewed by 901
Abstract
Background and Objectives: Adrenal gland tumors are frequently discovered incidentally. They remain challenging to evaluate because of their heterogeneous nature and overlapping imaging characteristics. Surgical resection continues to represent the primary treatment option for both benign and malignant lesions. This study aimed [...] Read more.
Background and Objectives: Adrenal gland tumors are frequently discovered incidentally. They remain challenging to evaluate because of their heterogeneous nature and overlapping imaging characteristics. Surgical resection continues to represent the primary treatment option for both benign and malignant lesions. This study aimed to characterize the clinical, demographic, and pathological features of adrenal tumors and to assess surgical management patterns in a tertiary referral center. Materials and Methods: A retrospective analysis was conducted on 112 patients who underwent adrenalectomy between 2015 and 2022. Demographic, clinical, radiological, and surgical data were reviewed. Histopathological findings were classified as benign tumors, primary adrenal malignancies, or adrenal metastases. Both laparoscopic adrenalectomy and open surgery were performed. The operative approach was determined by tumor characteristics and oncologic considerations. Results: Among the 112 patients, 48% had benign adrenal tumors, 32% had adrenal metastases, and 19.6% were diagnosed with primary adrenal malignancies. Most patients with adrenocortical carcinoma were women over 55 years of age. Benign lesions were predominantly managed with simple adrenalectomy and minimally invasive techniques, while malignant tumors frequently required complex oncologic resections and open surgical approaches. Distinct metastatic patterns were observed, with renal cell carcinoma representing the most common primary source of adrenal metastasis. Conclusions: Adrenal tumors demonstrate marked demographic and pathological variability. Surgical resection remains essential for definitive diagnosis and treatment, underscoring the importance of tailoring the operative approach. Minimally invasive surgery is appropriate for benign lesions, whereas open adrenalectomy is preferred for malignant or advanced tumors, where surgical expertise is critical to achieving optimal oncologic outcomes. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Urologic Oncology)
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13 pages, 1520 KB  
Article
Prognostic Significance of Ultralow (UL) Prostate-Specific Antigen (PSA) in Patients with Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): A Single Institution and Tertiary Cancer Center Experience
by Petar Suton and Višnja Gregov
Medicina 2025, 61(12), 2110; https://doi.org/10.3390/medicina61122110 - 27 Nov 2025
Viewed by 1350
Abstract
Background and objectives: Prostate-specific antigen (PSA) concentration is considered an important prognostic marker, with rapid and large reductions associated with a favorable outcome and prolonged survival. Material and Methods: We conducted a single institution and tertiary cancer center retrospective analysis of metastatic hormone-sensitive [...] Read more.
Background and objectives: Prostate-specific antigen (PSA) concentration is considered an important prognostic marker, with rapid and large reductions associated with a favorable outcome and prolonged survival. Material and Methods: We conducted a single institution and tertiary cancer center retrospective analysis of metastatic hormone-sensitive prostate cancer (mHSPC) patients undergoing active treatment at Division of Oncology and Radiotherapy, University Hospital Dubrava, between December 2022 and August 2025. This study aimed to assess the association between the PSA levels and survival in mHSPC patients undergoing active treatment. Results: A total of 42 (59.2%) in our cohort achieved UL PSA levels, while 29 patients (40.8%) had PSA levels > 0.2 ng/mL. Cox regression analysis identified age > 71 years at the diagnosis of mHSPC and UL PSA levels as statistically significant factors associated with favorable outcome. Conclusions: Our real-world data demonstrated that UL PSA is a favorable prognostic factor associated with prolonged survival and improved prognosis. However, we identified patients achieving UL PSA levels, who experienced radiographic progression. Our finding suggests that even among “best” PSA responders, some might develop resistant clones that manifest via imaging progression without PSA rise. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Urologic Oncology)
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17 pages, 1417 KB  
Article
Comparison of Ultrapreservation and Retzius-Sparing Techniques in Robotic Radical Prostatectomy: Single-Center Experience
by Murat Beyatlı, Hasan Samet Güngör, Hakan Bahadir Haberal, Abdurrahman İnkaya, Resul Sobay, Ahmet Tahra and Eyüp Veli Küçük
Medicina 2025, 61(10), 1851; https://doi.org/10.3390/medicina61101851 - 15 Oct 2025
Cited by 1 | Viewed by 2056
Abstract
Background and Objectives: This study aimed to compare perioperative, functional, and oncological outcomes of ultrapreservation and Retzius-sparing techniques in robotic radical prostatectomy for patients with localized prostate cancer. Materials and Methods: We retrospectively evaluated data from 189 patients who underwent robotic [...] Read more.
Background and Objectives: This study aimed to compare perioperative, functional, and oncological outcomes of ultrapreservation and Retzius-sparing techniques in robotic radical prostatectomy for patients with localized prostate cancer. Materials and Methods: We retrospectively evaluated data from 189 patients who underwent robotic radical prostatectomy using either the ultrapreservation (n = 97) or the Retzius-sparing (n = 92) technique by a single surgeon at a single center between January 2022 and November 2024. Patients were divided into two groups based on the surgical technique. Demographics, perioperative outcomes, functional outcomes (continence and potency), oncological outcomes, and complications were compared. Results: There were no statistically significant differences in baseline demographics between the groups (p > 0.05). The ultrapreservation group demonstrated superior perioperative outcomes: operative time (174.8 vs. 188.7 min, p < 0.001), console time (112.4 vs. 132.0 min, p < 0.001), blood loss (119.0 vs. 133.3 mL, p = 0.002), and hospital stay (2.3 vs. 2.5 days, p = 0.004) were all significantly shorter. Complication rates were comparable between groups (8.2% vs. 10.9%). In terms of continence, the Retzius-sparing group achieved earlier recovery after catheter removal (56.5% vs. 27.8%, p < 0.001), while long-term continence outcomes were similar (12-month: 93.8% vs. 91.3%, p = 0.703). Potency recovery favored the ultrapreservation group at 3 and 6 months postoperatively (3 months: 76.9% vs. 41.2%, p < 0.001; 6 months: 79.5% vs. 60.0%, p = 0.013). Oncological outcomes were comparable between groups. Conclusions: Both ultrapreservation and Retzius-sparing techniques provide safe oncological outcomes with distinct functional advantages. The ultrapreservation technique offers perioperative advantages and superior potency recovery, while the Retzius-sparing approach facilitates faster early continence recovery. Clinical decision-making should be individualized: ultrapreservation may be preferred in younger patients with good preoperative potency prioritizing erectile function preservation, while Retzius-sparing may benefit patients prioritizing immediate continence recovery, particularly those with baseline erectile dysfunction or advanced age. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Urologic Oncology)
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18 pages, 5441 KB  
Article
Proteomic and In Silico Analyses Highlight Complement System’s Role in Bladder Cancer Immune Regulation
by Tuğcan Korak, İbrahim Halil Baloğlu, Murat Kasap, Elif Damla Arisan, Gurler Akpinar and Serdar Arisan
Medicina 2025, 61(4), 735; https://doi.org/10.3390/medicina61040735 - 16 Apr 2025
Cited by 5 | Viewed by 2368
Abstract
Background and Objectives: Bladder cancer (BLCA), intimately associated with the immune system, represents a substantial global health burden due to its high recurrence rates and limited therapeutic effectiveness. Although immunotherapy shows promise, challenges persist due to the lack of reliable therapeutic targets. [...] Read more.
Background and Objectives: Bladder cancer (BLCA), intimately associated with the immune system, represents a substantial global health burden due to its high recurrence rates and limited therapeutic effectiveness. Although immunotherapy shows promise, challenges persist due to the lack of reliable therapeutic targets. This study aims to investigate potential immune-related biomarkers that could influence the tumor microenvironment in BLCA, using proteomic and in silico approaches. Materials and Methods: Tissue samples from BLCA patients (n = 27) and controls (n = 27) were collected from Şişli Hamidiye Etfal Training and Research Hospital. Proteomic analysis was performed by liquid chromatography/mass spectrometry (LC-MS)/MS to reveal the identities of differentially regulated proteins. Protein network analysis and hub protein detection were performed using Cytoscape (v.3.10.3), while functional annotation was carried out using EnrichR. The immunological analysis of hub proteins was performed in Sangerbox platform, and prognostic associations were evaluated through the Kaplan–Meier Plotter tool. Results: LC-MS/MS analysis identified 120 differentially regulated immune-related proteins. STRING analysis, using an immune response dataset (GO:0006955), highlighted the complement cascade as a significantly enriched pathway (p < 0.05). Proteins, namely C4A, CFB, C4B, C8B, CFH, CFI, C5, C4BPA, C3, and C2, that are known to play key roles in the complement system were identified. Immunological analysis with these proteins revealed the phenomena of immune infiltration and immune checkpoint gene associations (p < 0.05). Four hub genes—CFB, C4B, CFI, and C2—demonstrated a significant prognostic value for BLCA (p < 0.05). Conclusions: This study highlights the pivotal role of the complement system in the immune regulation of BLCA. CFI, C4A, and C4B emerged as potential target proteins for BLCA treatment, particularly in immunotherapy, for enhancing survival. Future research on these proteins and the complement system specifically focusing on BLCA may facilitate the development of targeted immunotherapies, ultimately improving treatment outcomes. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Urologic Oncology)
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Review

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12 pages, 280 KB  
Review
Prostate-Specific Membrane Antigen Positron Emission Tomography (PSMA-PET) in Initial Staging of Prostate Cancer Patients: The Beginning of a New Era
by Juan Gómez Rivas, Irene de la Parra, Sarelis Infante, Laura Ibañez, Beatriz Gutierrez Hidalgo, María Nieves Cabrera, Javier Puente, Noelia Sanmamed, Luis Enrique Ortega Polledo, María Isabel Galante and Jesús Moreno Sierra
Medicina 2025, 61(5), 924; https://doi.org/10.3390/medicina61050924 - 20 May 2025
Cited by 1 | Viewed by 1903
Abstract
Background and Objectives: Prostate cancer (PCa) is a common disease, with a significant number of patients initially diagnosed with locoregional or distant metastases. This is why it is essential to have imaging tests with sufficient sensitivity and specificity. Given the recognized limitations of [...] Read more.
Background and Objectives: Prostate cancer (PCa) is a common disease, with a significant number of patients initially diagnosed with locoregional or distant metastases. This is why it is essential to have imaging tests with sufficient sensitivity and specificity. Given the recognized limitations of traditional imaging methods, PSMA-PET has emerged as a promising tool that may revolutionize the management of PCa. Material and Methods: We conducted a comprehensive literature review from August to October 2023 using databases and a review of key clinical guidelines on the topic, focusing on the sensitivity and specificity of PSMA-PET, its use in detecting lymph node metastases (LNm), its integration into nomograms, its comparison with conventional imaging and current guideline recommendations. Results: After considering the search strategy, as well as the inclusion and exclusion criteria, four articles and five guidelines were particularly considered in this review. Most of them suggest high specificity and limited sensitivity for 68Ga-PSMA-PET, with increased detection rates compared to conventional imaging modalities, especially in high-risk PCa patients. However, it cannot replace an extended pelvic lymph node dissection (ePLND) at this time. Conclusions: Although the enhanced sensitivity and specificity of PSMA-PET relative to conventional imaging modalities offers a more precise evaluation of disease extent, prospective studies demonstrating a survival benefit are currently lacking; therefore, caution is advised when making therapeutic decisions. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Urologic Oncology)
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