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Advances and Future Perspectives in Diagnosis and Treatment of Urothelial...
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Advances and Future Perspectives in Diagnosis and Treatment of Urothelial Cell Carcinoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Pathophysiology".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 7850

Special Issue Editors

Dr. Andrea Mari

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Guest Editor
Oncologic Minimally Invasive Urology and Andrology Unit, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy
Interests: urothelial clinical biomarkers; prognostication; endoscopic surgery; robotics
Special Issues, Collections and Topics in MDPI journals
Dr. Benjamin Pradere

E-Mail Website
Guest Editor
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
Interests: onco-urology; Bladder cancer; UTUC; robotic surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Jeremy Yuen-Chun Teoh

E-Mail Website
Guest Editor
Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
Interests: tumour heterogeneity and molecular subtypes of bladder cancer; en bloc resection of bladder tumour and robotic cystectomy

Special Issue Information

Dear Colleagues,

The field of research in urothelial cancer has seen significant advances in recent years from diagnosis to treatment, as well as the implementation of prognostic models.

In detail, next-generation sequencing technologies have allowed us to deeply understand the genes most involved in bladder cancer pathogenesis. Non-invasive methods of diagnosis, including liquid biopsies, have seen major advances as well. However, most of these innovative tools need clinical validation.

Moreover, the use of immune checkpoint inhibitor drugs has brought a revolutionary therapeutic approach in patients with advanced and metastatic urothelial cancer.

In parallel, in the last decade, robotic surgery has increasingly been adopted for the treatment of bladder cancer and upper tract urothelial carcinoma with the purpose of decreasing treatment-related morbidity. Lastly, several predictive nomograms and prognostic models have been proposed to improve patient selection and more accurately forecast oncologic outcomes.

Overall, although these developments may provide benefits in terms of improved survival and quality of life, there are several unmet needs before we can effectively cure patients with urothelial cancer and reduce the levels of morbidity associated with treatments.

This Special Issue aims to explore diagnostic and therapeutic advances in the treatment of urothelial carcinoma, including bladder, upper tract, and urethral tumors.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: novel diagnostic tools for bladder cancer, insights in molecular biology of bladder cancer, biomarkers in urothelial cancer, innovative imaging modalities in diagnosis and staging, bladder-sparing treatment options in muscle-invasive bladder cancer, minimally invasive approaches to bladder and upper tract urothelial carcinomas, systemic therapy for high risk urothelial cancers, and predictive and prognostic models in bladder cancer and urethral cancer.

We look forward to receiving your contributions.

Dr. Andrea Mari
Dr. Benjamin Pradere
Dr. Jeremy Yuen-Chun Teoh
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. Cancers 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 2900 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

  • Biomarkers
  • Diagnosis
  • Imaging
  • Nomogram
  • Prognosis
  • Robotics
  • Urothelial cancer

Published Papers (4 papers)

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Research

22 pages, 913 KiB  
Article
Comparing Oncological and Perioperative Outcomes of Open versus Laparoscopic versus Robotic Radical Nephroureterectomy for the Treatment of Upper Tract Urothelial Carcinoma: A Multicenter, Multinational, Propensity Score-Matched Analysis
by Nico C. Grossmann, Francesco Soria, Tristan Juvet, Aaron M. Potretzke, Hooman Djaladat, Alireza Ghoreifi, Eiji Kikuchi, Andrea Mari, Zine-Eddine Khene, Kazutoshi Fujita, Jay D. Raman, Alberto Breda, Matteo Fontana, John P. Sfakianos, John L. Pfail, Ekaterina Laukhtina, Pawel Rajwa, Maximillian Pallauf, Cédric Poyet, Giovanni E. Cacciamani, Thomas van Doeveren, Joost L. Boormans, Alessandro Antonelli, Marcus Jamil, Firas Abdollah, Guillaume Ploussard, Axel Heidenreich, Enno Storz, Siamak Daneshmand, Stephen A. Boorjian, Morgan Rouprêt, Michael Rink, Shahrokh F. Shariat and Benjamin Pradereadd Show full author list remove Hide full author list
Cancers 2023, 15(5), 1409; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers15051409 - 23 Feb 2023
Cited by 2 | Viewed by 1869
Abstract
Objectives: To identify correlates of survival and perioperative outcomes of upper tract urothelial carcinoma (UTUC) patients undergoing open (ORNU), laparoscopic (LRNU), and robotic (RRNU) radical nephroureterectomy (RNU). Methods: We conducted a retrospective, multicenter study that included non-metastatic UTUC patients who underwent RNU between [...] Read more.
Objectives: To identify correlates of survival and perioperative outcomes of upper tract urothelial carcinoma (UTUC) patients undergoing open (ORNU), laparoscopic (LRNU), and robotic (RRNU) radical nephroureterectomy (RNU). Methods: We conducted a retrospective, multicenter study that included non-metastatic UTUC patients who underwent RNU between 1990–2020. Multiple imputation by chained equations was used to impute missing data. Patients were divided into three groups based on their surgical treatment and were adjusted by 1:1:1 propensity score matching (PSM). Survival outcomes per group were estimated for recurrence-free survival (RFS), bladder recurrence-free survival (BRFS), cancer-specific survival (CSS), and overall survival (OS). Perioperative outcomes: Intraoperative blood loss, hospital length of stay (LOS), and overall (OPC) and major postoperative complications (MPCs; defined as Clavien–Dindo > 3) were assessed between groups. Results: Of the 2434 patients included, 756 remained after PSM with 252 in each group. The three groups had similar baseline clinicopathological characteristics. The median follow-up was 32 months. Kaplan–Meier and log-rank tests demonstrated similar RFS, CSS, and OS between groups. BRFS was found to be superior with ORNU. Using multivariable regression analyses, LRNU and RRNU were independently associated with worse BRFS (HR 1.66, 95% CI 1.22–2.28, p = 0.001 and HR 1.73, 95%CI 1.22–2.47, p = 0.002, respectively). LRNU and RRNU were associated with a significantly shorter LOS (beta −1.1, 95% CI −2.2–0.02, p = 0.047 and beta −6.1, 95% CI −7.2–5.0, p < 0.001, respectively) and fewer MPCs (OR 0.5, 95% CI 0.31–0.79, p = 0.003 and OR 0.27, 95% CI 0.16–0.46, p < 0.001, respectively). Conclusions: In this large international cohort, we demonstrated similar RFS, CSS, and OS among ORNU, LRNU, and RRNU. However, LRNU and RRNU were associated with significantly worse BRFS, but a shorter LOS and fewer MPCs. Full article
(This article belongs to the Special Issue Advances and Future Perspectives in Diagnosis and Treatment of Urothelial Cell Carcinoma)
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11 pages, 2669 KiB  
Article
Incidental Diagnosis of Urothelial Bladder Cancer: Associations with Overall Survival
by Hubert Kamecki, Małgorzata Dębowska, Jan Poleszczuk, Tomasz Demkow, Artur Przewor, Łukasz Nyk and Roman Sosnowski
Cancers 2023, 15(3), 668; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers15030668 - 21 Jan 2023
Cited by 3 | Viewed by 1457
Abstract
Background: We investigated whether an incidental diagnosis (ID) of bladder cancer (BC) was associated with improved survival. Methods: We retrospectively reviewed data of consecutive patients with no prior diagnosis of urothelial cancer who underwent a primary transurethral resection of bladder tumor (pTURBT) between [...] Read more.
Background: We investigated whether an incidental diagnosis (ID) of bladder cancer (BC) was associated with improved survival. Methods: We retrospectively reviewed data of consecutive patients with no prior diagnosis of urothelial cancer who underwent a primary transurethral resection of bladder tumor (pTURBT) between January 2013 and February 2021 and were subsequently diagnosed with urothelial BC. The type of diagnosis (incidental or non-incidental) was identified. Overall, relative, recurrence-free, and progression-free survival rates (OS, RS, RFS, and PFS) after pTURBT were evaluated using the Kaplan–Meier curves and long-rank tests. A multivariable Cox regression model for the overall mortality was developed. Results: A total of 435 patients were enrolled. The median follow-up was 2.7 years. ID cases were more likely to be low-grade (LG) and non-muscle-invasive. ID vs. non-ID was associated with a trend toward an improved 7-year OS (66% vs. 49%, p = 0.092) and a significantly improved 7-year OS, if incidental cases were limited to ultrasound-detected tumors (75% vs. 49%, p = 0.013). ID was associated with improved survival among muscle-invasive BC (MIBC) patients (3-year RS: 97% vs. 23%, p < 0.001), but not among other subgroups stratified according to disease stage or grade. In multivariable analysis, only age, MIBC, and high-grade (HG) cancer demonstrated an association with mortality. PFS and RFS among non-MIBC patients did not differ in regard to the type of diagnosis. Conclusions: Incidental diagnosis may contribute to an improved survival in BC patients, most probably in the mechanism of the relative downgrading of the disease, including the possible overdiagnosis of LG tumors. Nevertheless, in the subgroup analyses, we noted marked survival benefits in MIBC cases. Further prospective studies are warranted to gain a deeper understanding of the observed associations. Full article
(This article belongs to the Special Issue Advances and Future Perspectives in Diagnosis and Treatment of Urothelial Cell Carcinoma)
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13 pages, 1160 KiB  
Article
Adverse Prognostic Impact of Diagnostic Ureterorenoscopy in a Subset of Patients with High-Risk Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy
by Ichiro Yonese, Masaya Ito, Yuma Waseda, Shuichiro Kobayashi, Masahiro Toide, Ryoji Takazawa and Fumitaka Koga
Cancers 2022, 14(16), 3962; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14163962 - 17 Aug 2022
Cited by 2 | Viewed by 1047
Abstract
Background: We hypothesized that diagnostic ureterorenoscopy (URS) may adversely affect prognosis in a subset of patients with high-risk upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). Methods: The present retrospective study included 143 patients with UTUC treated between 2010 and 2021 at [...] Read more.
Background: We hypothesized that diagnostic ureterorenoscopy (URS) may adversely affect prognosis in a subset of patients with high-risk upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). Methods: The present retrospective study included 143 patients with UTUC treated between 2010 and 2021 at two tertiary care hospitals, of whom 79 received URS prior to RNU. Subgroups were stratified by clinicopathological variables relevant to prognosis. The primary endpoint was to evaluate the prognostic impact of URS on overall survival (OS) and progression-free survival (PFS) after RNU. Results: During follow-up (median 54 months for survivors), 32 cases of all-cause mortality and 40 cases of progression were recorded. No significant difference was found in OS or PFS between patients with and without URS. Subgroup analysis demonstrated that URS was significantly associated with worse OS (p < 0.001) and PFS (p = 0.008) in 29 patients with non-papillary and ≥pT3 UTUC. Importantly, URS did not have any adverse effects on prognosis in 62 patients with papillary and ≤pT2 UTUC (p = 0.005). Conclusions: URS may adversely affect prognosis of UTUC patients, specifically non-papillary and ≥pT3 disease. URS may better be avoided in patients with high-risk UTUC features unless URS is necessary to diagnose UTUC. This study also corroborates the oncological safety of URS in those with low-risk UTUC. Full article
(This article belongs to the Special Issue Advances and Future Perspectives in Diagnosis and Treatment of Urothelial Cell Carcinoma)
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20 pages, 1044 KiB  
Article
Pentafecta for Radical Nephroureterectomy in Patients with High-Risk Upper Tract Urothelial Carcinoma: A Proposal for Standardization of Quality Care Metrics
by Frederik König, Nico C. Grossmann, Francesco Soria, David D’Andrea, Tristan Juvet, Aaron Potretzke, Hooman Djaladat, Alireza Ghoreifi, Eiji Kikuchi, Nozomi Hayakawa, Andrea Mari, Zine-Eddine Khene, Kazutoshi Fujita, Jay D. Raman, Alberto Breda, Matteo Fontana, John P. Sfakianos, John L. Pfail, Ekaterina Laukhtina, Pawel Rajwa, Maximilian Pallauf, Giovanni E. Cacciamani, Thomas van Doeveren, Joost L. Boormans, Alessandro Antonelli, Marcus Jamil, Firas Abdollah, Jeffrey Budzyn, Guillaume Ploussard, Axel Heidenreich, Siamak Daneshmand, Stephen A. Boorjian, Morgan Rouprêt, Michael Rink, Shahrokh F. Shariat and Benjamin Pradereadd Show full author list remove Hide full author list
Cancers 2022, 14(7), 1781; https://0-doi-org.brum.beds.ac.uk/10.3390/cancers14071781 - 31 Mar 2022
Cited by 1 | Viewed by 2615
Abstract
Background: Measuring quality of care indicators is important for clinicians and decision making in health care to improve patient outcomes. Objective: The primary objective was to identify quality of care indicators for patients with upper tract urothelial carcinoma (UTUC) and to validate these [...] Read more.
Background: Measuring quality of care indicators is important for clinicians and decision making in health care to improve patient outcomes. Objective: The primary objective was to identify quality of care indicators for patients with upper tract urothelial carcinoma (UTUC) and to validate these in an international cohort treated with radical nephroureterectomy (RNU). The secondary objective was to assess the factors associated with failure to validate the pentafecta. Design: We performed a retrospective multicenter study of patients treated with RNU for EAU high-risk (HR) UTUC. Outcome measurements and statistical analysis: Five quality indicators were consensually approved, including a negative surgical margin, a complete bladder-cuff resection, the absence of hematological complications, the absence of major complications, and the absence of a 12-month postoperative recurrence. After multiple imputations and propensity-score matching, log-rank tests and a Cox regression were used to assess the survival outcomes. Logistic regression analyses assessed predictors for pentafecta failure. Results: Among the 1718 included patients, 844 (49%) achieved the pentafecta. The median follow-up was 31 months. Patients who achieved the pentafecta had superior 5-year overall- (OS) and cancer-specific survival (CSS) compared to those who did not (68.7 vs. 50.1% and 79.8 vs. 62.7%, respectively, all p < 0.001). On multivariable analyses, achieving the pentafecta was associated with improved recurrence-free survival (RFS), CSS, and OS. No preoperative clinical factors predicted a failure to validate the pentafecta. Conclusions: Establishing quality indicators for UTUC may help define prognosis and improve patient care. We propose a pentafecta quality criteria in RNU patients. Approximately half of the patients evaluated herein reached this endpoint, which in turn was independently associated with survival outcomes. Extended validation is needed. Full article
(This article belongs to the Special Issue Advances and Future Perspectives in Diagnosis and Treatment of Urothelial Cell Carcinoma)
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