Advancements in the Diagnosis and Surgical Treatment of Prostate Cancer

Dear Colleagues,

Diagnostic and therapeutic approaches for localized prostate cancer (PCa) have substantially improved over the past two decades. The implementation of targeted biopsy, based on MRI/ultrasound fusion, for suspicious prostate lesions has led to better discrimination of clinically significant PCa. This approach has also allowed for a more precise surgical intervention, balancing oncological safety and maximal preservation of functionality. The introduction of robot-assisted radical prostatectomy (RARP) in the 2000s quickly became a globally accepted standard of care. Since then, it has undergone several evolutionary steps based on further innovations, resulting in the development and establishment of new systems.

Despite overall satisfactory oncological and functional outcomes, some scientific questions remain unanswered, providing room for robust data analyses presented in international journals and major urological congresses. Unanswered questions include the impact of learning curves and the necessary case volumes to achieve stable and reproducible quality, applicable to both diagnostic fusion therapy and various modifications of RARP. The significance of pelvic lymph node dissection continues to be controversial, particularly considering that symptomatic lymphoceles are nearly the only quantitatively relevant complication after RARP. Another question lacking sufficient evidence is whether single-port procedures or RARP with "new systems" can achieve comparable oncological and functional safety.

The scope of this Special Issue is intentionally broad, as, in the spirit of the German poet Theodor Fontane, 'the inseparably connected diagnosis and treatment of localized prostate cancer truly represent a wide field'. We invite academically and clinically active urologists from around the world to contribute their results and perspectives in the form of original research articles and systematic review articles for discussion.

Dr. Christian Peter Gilfrich
Prof. Dr. Christian Thomas
Guest Editors

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• robotic-assisted radical prostatectomy
• significance of pelvic lymph node dissection in the context of radical prostatectomy
• complications of surgical therapy for prostate cancer
• magnetic resonance imaging/ultrasound-guided target biopsy of the prostate
• comparison of various robotic systems for radical prostatectomy
• learning curves
• hospital volume
• prostate cancer centers