Robot-Assisted Radical Prostatectomy for Urologic Cancer: State of the Art

Dear Colleagues,

Prostate cancer (PCa) is the second most common malignancy diagnosed in men worldwide and radical prostatectomy (RP) remains the mainstay therapy for organ-confined disease. The technological revolution, along with sophisticated improvements in surgical techniques, has led to the predominance of robotic surgery over previous RP approaches. Currently, in most advanced health systems, robot-assisted radical prostatectomy (RALP) is the most prevalent surgical approach in PCa therapy.

Numerous robotic platforms have been recently introduced and their urological applications have been consistently studied, including RALP (SP daVinci, Kang Duo, Hugo, and Dexter, to list a few). Surgery has become less invasive and better studied, with shorter learning curves in tertiary, high-volume centers, where RALP has resulted in lower rates of positive surgical margins, with lower morbidity. Combined with modern imaging (multiparametric MRI, PET/PSMA) and molecular markers, the treatment landscape of PCa is changing. RALP has become more individualized and is tailored to patient needs and expectations. Neoadjuvant and adjuvant therapies will further shape PCa surgical management.    

Despite all the efforts and obvious progress, a third of patients subjected to RALP develop biochemical failure. Understanding the best candidates for surgery, in whom it could, and should, be omitted due to a low risk of cancer progression or unacceptable risk of morbidity, and in whom it should be preceded with neoadjuvant therapy or supplemented with radiation or systemic management remain still to be seen. This Special Issue will highlight the role of robot-assisted surgery in the current and future landscape of prostate cancer therapy. A number of clinical applications and their utility will be presented and discussed.

Prof. Dr. Jakub Dobruch
Guest Editor

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• prostate cancer
• bladder cancer
• upper urinary tract tumors
• kidney cancer
• testicular tumors
• molecular markers
• lymph node metastasis
• diagnosis
• radical treatment
• systemic treatment