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Urologic Oncology: From Diagnosis to Treatments

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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 September 2024) | Viewed by 8005

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Special Issue Editors

Prof. Dr. Riccardo Autorino

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Guest Editor

Department of Urology, Rush University Medical Center, Chicago, IL, USA
Interests: prostate cancer; laparoscopic surgery; minimally invasive surgery; surgical oncology; robotic surgery; bladder cancer
Special Issues, Collections and Topics in MDPI journals

Dr. Celeste Manfredi

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Guest Editor

1. Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
2. Department of Urology, Rush University Medical Center, Chicago, IL, USA
Interests: urology; uro-oncology; andrology; sexual medicine; benign prostatic hyperplasia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Urologic cancer research is a dynamic and critical field dedicated to unraveling the characteristics of tumors affecting the genitourinary system. Its primary aim is to develop our understanding in order to improve the management of these complex diseases.

Researchers tirelessly explore the intricate genetic and molecular mechanisms underlying the initiation and progression of urological cancers, paving the way for personalized diagnostic and therapeutic strategies. Robotic surgery has become widespread, with it already being a cornerstone in the treatment of many urologic malignancies. Continuous efforts are conducted by scientists to improve the accuracy of diagnostic tools, the efficacy and safety of medical treatments, the outcomes of surgical techniques, and ultimately, the patients' prognosis and quality of life.

In this Special Issue, we invite authors to submit papers on the recent advances and future perspectives of epidemiology, risk factors, pathophysiology, and the diagnosis and/or treatment of main urologic tumors.

Prof. Dr. Riccardo Autorino
Dr. Celeste Manfredi
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 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
bladder cancer
upper tract urothelial cancer
testicular cancer
renal cancer
adrenal cancer
penis cancer
robotic surgery
personalized medicine

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Published Papers (5 papers)

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Research

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11 pages, 737 KiB

Open AccessArticle

Radiological Assessment of Different Retroperitoneal Lymph Node Measurements in Stage 1 Testicular Cancer Patients: Impact on Clinical Stage and Treatment

by Angelina Strauch, Kai Nestler, Justine Schoch, Laura Kubitscheck, Stephan Waldeck, Hans Schmelz and Tim Nestler

J. Clin. Med. 2024, 13(18), 5553; https://doi.org/10.3390/jcm13185553 - 19 Sep 2024

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Abstract

Background: In staging for testicular germ cell tumor (GCT), current guidelines lack consensus regarding the measurement of retroperitoneal lymph node metastasis, concerning the recommended plane and dimension. This exploratory study aimed to assess its impact on clinical stage (cS) and therapy. Methods: We retrospectively examined 154 cSI (retroperitoneal lymph nodes < 10 mm in axial short-axis diameter (SAD)) GCT patients, without adjuvant therapy and a follow-up ≥ 24 months. Retroperitoneal lymph nodes were measured in staging images in different dimensions (SAD and long-axis diameter (LAD)) and planes (axial, sagittal and coronal). Results: Overall survival was 100%, with 82% free of recurrence after a median follow-up of 83 months. All patients were classified as cSI, based on axial SAD (RECIST 1.1). However, significantly more patients would have been classified as cSIIA (0% vs. 38% vs. 52%) or even cSIIB (0% vs. 1% vs. 25%) according to axial LAD (SWENOTECA, German S3 guideline) or maximum LAD in any plane (EAU, ESMO, AJCC and onkopedia) (p < 0.001). Overtreatment was predicted in 0%, 31% and 61% of patients based on axial SAD, axial LAD and maximum LAD, while undertreatment was estimated at 18%, 10% and 2%, respectively, (p < 0.001). Conclusions: These findings indicate considerable variability in cS based on current lymph node staging recommendations, suggesting that axial SAD (RECIST 1.1) could be the most appropriate parameter for standardized guideline recommendations. Full article

(This article belongs to the Special Issue Urologic Oncology: From Diagnosis to Treatments)

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11 pages, 549 KiB

Open AccessArticle

Open versus Minimally Invasive Partial Nephrectomy: Trends and Outcomes from a Wide National Population-Based Database

by Antonio Franco, Riccardo Lombardo, Francesco Ditonno, Eugenio Bologna, Leslie Claire Licari, Omar Nabulsi, Darren Ioos, Giacomo Gallo, Giorgia Tema, Antonio Cicione, Antonio Nacchia, Andrea Tubaro, Cosimo De Nunzio, Edward E. Cherullo and Riccardo Autorino

J. Clin. Med. 2024, 13(18), 5454; https://doi.org/10.3390/jcm13185454 - 14 Sep 2024

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Abstract

Objectives: To investigate temporal trends and overall complication rates among open partial nephrectomy (OPN) and minimally invasive partial nephrectomy (MIPN), including the impact of social determinants of health (SDOH) on postoperative outcomes. Methods: Patients who underwent OPN or MIPN between 2011 and 2021 were retrospectively analyzed by using PearlDiver-Mariner, an all-payer insurance claims database. The International Classification of Diseases diagnosis and procedure codes were used to identify the type of surgical operation, patient’s characteristics (age, sex, region, insurance plan), postoperative complications and SDOH, categorized in education, healthcare, environmental, social, and economic domains. Outcomes were compared using multivariable regression models. Results: Overall, 65,325 patients underwent OPN (n = 23,377) or MIPN (n = 41,948). OPN adoption declined over the study period, whereas that of MIPN increased from 24% to 34% (p = 0.001). The 60-day postoperative complication rate was 15% for the open and 9% for the minimally invasive approach. Approximately 16% and 11% of patients reported at least one SDOH at baseline for OPN and MIPN, respectively. SDOH were associated with higher odds of postoperative complications (OPN = OR: 1.11, 95% CI: 1.01–1.25; MIPN = OR: 1.31, 95% CI: 1.18–1.46). The open approach showed a significantly higher risk of postoperative complications (OR: 1.62, 95% CI: 1.54–1.70) compared to the minimally invasive one. Conclusions: Our findings confirm that MIPN is gradually replacing OPN, which carries a higher risk of complications. SDOH are significant predictors of postoperative complications following PN, regardless of the approach. Full article

(This article belongs to the Special Issue Urologic Oncology: From Diagnosis to Treatments)

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13 pages, 952 KiB

Open AccessArticle

The Feasibility and Diagnostic Adequacy of PD-L1 Expression Analysis Using the Cytoinclusion Technique in Bladder Cancer: A Prospective Single-Center Study

by Luca Di Gianfrancesco, Isabella Monia Montagner, Debora Tormen, Alessandro Crestani, Antonio Amodeo, Paolo Corsi, Davide De Marchi, Eugenio Miglioranza, Giuliana Lista, Francesca Simonetti, Gian Maria Busetto, Martina Maggi, Filippo Marino, Antonio Scapinello and Angelo Porreca

J. Clin. Med. 2024, 13(14), 4072; https://doi.org/10.3390/jcm13144072 - 12 Jul 2024

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Background: Programmed death-ligand 1 (PD-L1) expression has been recognized as a potential biomarker for various cancers, yet its diagnostic and prognostic significance in urothelial bladder cancer (BCa) requires further investigation. Methods: In this prospective single-center study, we aimed to assess the feasibility and diagnostic adequacy of PD-L1 expression analysis using cytoinclusion in BCa patients. We enrolled consecutive patients undergoing endoscopic transurethral resection of bladder tumor (TURBT), repeat TURBT, or robot-assisted radical cystectomy. Urinary and tissue specimens were collected from these patients for cytoinclusion and histopathological analysis to evaluate PD-L1 expression. Results: Out of 29 patients, PD-L1 expression was detected from cytoinclusion in 42.8% (3 out of 7), 10% (1 out of 10), and 66.8% (8 out of 12) of patients with negative/papilloma, low-grade, and high-grade tumors, respectively. Conversely, histopathological analysis identified PD-L1 expression in 57.2% (4 out of 7), 30% (3 out of 10), and 83.3% (10 out of 12) of patients with negative/papilloma, low-grade, and high-grade tumors, respectively. The diagnostic concordance between cytoinclusion and histopathology was 85.7%, 80%, and 83.3% in patients with negative/papilloma, low-grade, and high-grade tumors, respectively. Conclusions: Our study underscores the promise of cytoinclusion as a minimally invasive method for quantifying urinary PD-L1 percentages. This approach could serve as both a potential prognostic and diagnostic indicator, easily obtainable from urine samples. Standardizing this technique could facilitate its widespread use as a valuable tool. Full article

(This article belongs to the Special Issue Urologic Oncology: From Diagnosis to Treatments)

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12 pages, 483 KiB

Open AccessArticle

Adjuvant Chemotherapy in Patients with Locally Advanced Upper Tract Urothelial Carcinoma with or without Kidney Transplantation

by Nai-Wen Chang, Yu-Hui Huang, Wen-Wei Sung and Sung-Lang Chen

J. Clin. Med. 2024, 13(7), 1831; https://doi.org/10.3390/jcm13071831 - 22 Mar 2024

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Abstract

Background: The incidence of upper tract urothelial carcinoma (UTUC) is uniquely high in kidney transplant (KT) recipients in Taiwan. The evidence of adjuvant chemotherapy (AC) in UTUC is contradictory. We have sought to determine whether AC is associated with potential benefits related to locally advanced UTUC after KT. Methods: We retrospectively analyzed 134 patients with locally advanced UTUC (at least stage T2) and patients who were administrated AC after unilateral or bilateral nephroureterectomy with bladder cuff excision. Of these 134 patients, 57 patients fulfilled our inclusion criteria. We used 23 KT and 34 non-KT locally advanced UTUC patients for comparison. Results: The mean follow-up time was 52.35 ± 34.56 and 64.71 ± 42.29 months for the KT and non-KT groups, respectively. The five-year disease-free survival (DFS) and overall survival (OS) rates were 45.7% vs. 70.2% and 62.8% vs. 77.6%, for the KT and non-KT groups. The Kaplan–Meier curve and the log rank test revealed significant differences in the DFS and OS rates between the two groups, p = 0.015 and 0.036. The influence of chemotherapy on graft kidney function was mild. Only three in the KT group and two in the non-KT group developed > grade 2 nephrotoxicity. Conclusions: Our study suggested that KT patients with locally advanced UTUC who had been administered AC after surgery presented worse OS and DFS than non-KT patients. KT patients tolerated the AC course well, and their nephrotoxicity levels were mild and acceptable. Full article

(This article belongs to the Special Issue Urologic Oncology: From Diagnosis to Treatments)

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Review

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13 pages, 245 KiB

Open AccessReview

Epirubicin and Non-Muscle Invasive Bladder Cancer Treatment: A Systematic Review

by Sever Chiujdea, Matteo Ferro, Mihai Dorin Vartolomei, Giuseppe Lucarelli, Kensuke Bekku, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Ichiro Tsuboi, Tamas Fazekas, Stefano Mancon and Shahrokh F. Shariat

J. Clin. Med. 2024, 13(13), 3789; https://doi.org/10.3390/jcm13133789 - 27 Jun 2024

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Abstract

(1) Background: Intravesical chemotherapy is the standard of care in intermediate-risk non-muscleinvasive bladder cancer (NMIBC). Different agents are used across the world based on availability, cost, and practice patterns. Epirubicin (EPI), one of these agents, has been used by many centers over many decades. However, its true differential efficacy compared to other agents and its tolerability are still poorly reported. We aimed to assess the differential efficacy and safety of intravesical EPI in NMIBC patients. (2) Methods: This study aimed to systematically review the efficacy and safety profile of Epirubicin (EPI) in the management of non-muscle invasive bladder cancer (NMIBC) compared to other adjuvant therapies. A systematic search of the PUBMED, Web of Science, clinicaltrials.gov, and Google Scholar databases was conducted on 31 December 2023, using relevant terms related to EPI, bladder cancer, and NMIBC. The inclusion criteria targeted studies that evaluated patients treated with EPI following the transurethral resection of bladder tumors (TURBT) for NMIBC and compared oncological outcomes such as recurrence and progression with other adjuvant therapies, including Mitomycin C (MMC), Gemcitabine (GEM), and Bacillus Calmette-Guérin (BCG). Additionally, studies investigating the safety profile of EPI administered intravesically at room temperature and under hyperthermia, as well as oncological outcomes associated with hyperthermic intravesical EPI administration, were included. (3) Results: Eleven studies reported adverse events after adjuvant intravesical instillations with EPI; the most frequently reported adverse events included cystitis (34%), dysuria, pollakiuria, hematuria, bladder irritation/spasms, fever, nausea and vomiting, and generalized skin rash (2.3%). Nine studies compared EPI to BCG in terms of recurrence and progression rates; BCG instillations showed a lower recurrence rate compared to EPI, with limited or non-significant differences in progression rates. Two studies found no significant differences between EPI and MMC regarding progression and recurrence rates. One study showed statistically significant lower recurrence and progression rates with GEM in high-risk NMIBC patients. Another study found no significant differences between EPI and GEM regarding recurrence and progression. (4) Conclusions: EPI exhibits similar oncological performances to Gemcitabine and Mitomycin C currently used for adjuvant therapy in NMIBC. Novel delivery mechanisms such as hyperthermia are interesting newcomers. Full article

(This article belongs to the Special Issue Urologic Oncology: From Diagnosis to Treatments)

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