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Cancers
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Novel Advances in Surgery for Prostate Cancer
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Novel Advances in Surgery for Prostate Cancer

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

Deadline for manuscript submissions: 30 November 2025 | Viewed by 5811

Special Issue Editor

Dr. Vincenzo De Marco

E-Mail Website
Guest Editor
Azienda Ospedaliera Universitaria Integrata—Borgo Trento Hospital, Verona, Italy
Interests: prostate cancer; radical prostatectomy; robot-assisted surgery; robotic surgery

Special Issue Information

Dear Colleagues,

We are excited to present the Special Issue entitled "Novel Advances in Surgery for Prostate Cancer", featuring cutting-edge insights into the surgical management of prostate cancer. This collection highlights innovative technologies and techniques aimed at refining diagnosis, treatment, and patient outcomes. Leading experts contribute diverse articles exploring state-of-the-art image-guided technologies, robot-assisted technologies, adoption of novel robotic platforms, and other minimally invasive approaches. Addressing a global health challenge, these advancements underscore the importance of precision and patient-centric strategies. We extend our gratitude to contributors for enriching this Special Issue, anticipating its role as a valuable resource for clinicians, surgeons, and researchers, fostering continued progress in prostate cancer surgery.

Dr. Vincenzo De Marco
Guest Editor

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 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

  • prostate cancer
  • radical prostatectomy
  • robot-assisted surgery
  • robotic platform
  • technology
  • single port
  • alternative approaches
  • focal therapy

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Published Papers (3 papers)

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Research

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35 pages, 1541 KB  
Article
Real-Life Comparative Analysis of Robotic-Assisted Versus Laparoscopic Radical Prostatectomy in a Single Centre Experience
by Stefano Salciccia, Valerio Santarelli, Giovanni Battista Di Pierro, Francesco Del Giudice, Giulio Bevilacqua, Giovanni Di Lascio, Alessandro Gentilucci, Roberta Corvino, Valentina Brunelli, Greta Basile, Carlo Maria Scornajenghi, Lorenzo Santodirocco, Luca Gobbi, Davide Rosati, Martina Moriconi, Valeria Panebianco, Fabio Massimo Magliocca, Daniele Santini, Mattia Alberto Di Civita, Flavio Forte, Marco Frisenda, Giorgio Franco and Alessandro Sciarraadd Show full author list remove Hide full author list
Cancers 2024, 16(21), 3604; https://doi.org/10.3390/cancers16213604 - 25 Oct 2024
Cited by 3 | Viewed by 1697
Abstract
Background: The advantage of a robotic-assisted (RARP) over a laparoscopic (LRP) approach in radical prostatectomy (RP) remains to be demonstrated. Aim: The aim of the study is to use a homogeneous population in real life and single primary surgeon surgery to [...] Read more.
Background: The advantage of a robotic-assisted (RARP) over a laparoscopic (LRP) approach in radical prostatectomy (RP) remains to be demonstrated. Aim: The aim of the study is to use a homogeneous population in real life and single primary surgeon surgery to analyze the oncological and functional results based on the type of surgical approach and pathological features. Methods: This is a prospective trial on non-metastatic prostate cancer (PCa) patients considered after a multidisciplinary decision to conduct a RP, using a RARP or LRP approach. A real-life setting was analyzed at our Urological Departments using homogeneous criteria for the management of PCa cases and a single surgeon experience on 444 cases (284 LRP and 160 RARP). Results: Mean operating time was significantly lower in RARP (153.21 ± 25.1 min) than in LRP (173.33 ± 44.3 min) (p < 0.001). In cases submitted to an extended lymph node dissection (eLND), the mean number of lymph nodes removed was 15.16 ± 7.83 and 19.83 ± 4.78, respectively, in LRP and RARP procedures (p < 0.001), but positive lymph nodes (pN1) were similarly found in 15.8% of LRP patients and 13.6% of RARP patients (p = 0.430). Surgical margins (SM) positivity was not significantly higher in the RARP group (20.0%) when compared to the LRP group (15.9%) (p = 0.145). During the postoperative follow-up, a biochemical recurrence (BCR) was detected in 14.4% and 7.5% of cases in the LRP and RARP group, respectively, (p = 0.014). Better results of PAD tests at 3-month intervals using the RARP approach (mean pad weight 75.57 ± 122 g and 14 ± 42 g, respectively, in LRP and RARP (p < 0.01)) were described. Conclusions: In the comparison between the RARP and LRP approach, a clear advantage of the robotic approach is a significant reduction in operating times, days of hospitalization, and postoperative catheterization compared to laparoscopic surgery. It is not possible to describe any certain oncological advantage both in terms of surgical margins and pathological lymph nodes removed. In RARP cases a reduction to the limit of significance is described in terms of biochemical recurrence. RARP produces a more rapid recovery of urinary continence at 3 months postoperatively without significant advantages in terms of erective potency recovery. Full article
(This article belongs to the Special Issue Novel Advances in Surgery for Prostate Cancer)
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Review

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13 pages, 1925 KB  
Review
Recent Advances in Radical Prostatectomy: A Narrative Review of Surgical Innovations and Outcomes
by Seon Beom Jo and Jong Wook Kim
Cancers 2025, 17(5), 902; https://doi.org/10.3390/cancers17050902 - 6 Mar 2025
Cited by 1 | Viewed by 2818
Abstract
Prostate cancer is one of the most commonly diagnosed malignancies worldwide and is a major cause of cancer-associated morbidity in men. Radical prostatectomy (RP) is a cornerstone of intervention for organ-confined diseases and offers a potentially curative outcome. In recent decades, RP has [...] Read more.
Prostate cancer is one of the most commonly diagnosed malignancies worldwide and is a major cause of cancer-associated morbidity in men. Radical prostatectomy (RP) is a cornerstone of intervention for organ-confined diseases and offers a potentially curative outcome. In recent decades, RP has undergone transformative changes, moving from open surgery, with significant morbidity, to minimally invasive and robot-assisted techniques. These advances have improved surgical precision, reduced blood loss, and accelerated functional recovery. Key enhancements, such as the “Veil of Aphrodite”, hood-sparing, and Retzius-sparing approaches, aim to preserve neurovascular structures vital for continence and sexual function, addressing the persistent challenge of balancing oncological control with quality-of-life outcomes. Single-port (SP) robotic platforms represent the latest frontier, offering various access routes, including extraperitoneal, transvesical, transperitoneal, and transperineal routes, to further reduce incisional morbidity. Early experiences with SP robot-assisted radical prostatectomy(RARP) suggest favorable continence rates and short hospital stays, although concerns remain regarding the technical complexity and potential margin status of the advanced disease. Comparisons across these techniques revealed broadly similar long-term oncological outcomes, underscoring the importance of patient selection, tumor staging, and surgeon expertise. Ongoing innovations in robotic systems, augmented imaging modalities, and personalized surgical planning are likely to refine prostate cancer care and enhance both survival and post-treatment quality of life. Full article
(This article belongs to the Special Issue Novel Advances in Surgery for Prostate Cancer)
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Other

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18 pages, 2150 KB  
Systematic Review
Role of Radical Prostatectomy in Oligo-Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review and Meta-Analysis
by Karthik Rajan, Kalpesh Parmar, Shri-Ishvarya Rajamoorthy, Robert Geraghty, Eleanor Whyte and Bhavan Prasad Rai
Cancers 2025, 17(17), 2757; https://doi.org/10.3390/cancers17172757 - 24 Aug 2025
Viewed by 609
Abstract
Introduction and Aims: Androgen deprivation therapy (ADT) with systemic anti-cancer treatment (SACT) ± palliative radiotherapy (pRT) is the current standard of care for Oligo-metastatic hormone-sensitive prostate cancer (o-mHSPC). Cytoreductive radical prostatectomy (cRP) has gained interest in this group of patients, with potential benefits [...] Read more.
Introduction and Aims: Androgen deprivation therapy (ADT) with systemic anti-cancer treatment (SACT) ± palliative radiotherapy (pRT) is the current standard of care for Oligo-metastatic hormone-sensitive prostate cancer (o-mHSPC). Cytoreductive radical prostatectomy (cRP) has gained interest in this group of patients, with potential benefits including reduced tumour burden and a lower risk of local events from disease progression. In this review, we compare both survival outcomes and local event rates between cRP and upfront ADT ± SACT. Methods: All randomised trials and observational studies comparing cRP with standard treatment (ST), which we defined as ADT ± SACT for o-mHSPC, were included in the review. The study protocol was registered in PROSPERO (CRD42024516586), and the review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases searched included Embase, Medline, Cochrane Library, PubMed, and Web of Science. A risk of bias assessment was performed for the included studies as recommended by the Cochrane Handbook of Systematic Reviews and Interventions. The primary outcome measures were Overall Survival (OS), Cancer-Specific Survival (CSS), Progression-free Survival (PFS), Castrate-resistant Prostate Cancer-free Survival (CRPC-FS), and local complication rates. The secondary outcome measures were complication rates and functional outcomes post-cRP. Results: A total of 5130 studies were identified for this review (5119 by database searching and 11 through manual searching). Eight studies were included in the review, comprising 611 patients. cRP was identified to have superior OS (HR: 0.56 (95% CI: 0.34–0.92), I2 = 0%, p = 0.02 (very low certainty)) and CSS (HR: 0.27 (95% CI: 0.15–0.47), I2 = 0%, p < 0.0001 (very low certainty)). The PFS (HR: 0.67 (95% CI: 0.34–1.33), I2 = 58%, p = 0.25 (very low certainty)) and CRPC-FS (HR: 0.67 (95% CI: 0.32–1.43), I2 = 57%, p = 0.30 (very low certainty)) were similar between the two groups. The rates of local events were significantly lower in patients undergoing cRP (RR 0.27 (95% CI: 0.13–0.59), I2 = 17%, p = 0.001 (low certainty)). The rates of Clavien–Dindo (CD) grade 3 or higher complications ranged from 0% to 13.1%. Additionally, the reported continence rates ranged from 81.5% to 91.3%. The review is limited by the lack of a uniform definition for o-mHSPC and the predominance of low-quality, heterogeneous studies. Despite mitigation strategies, the overall certainty of evidence remains very low per GRADE assessment. Conclusion: cRP significantly reduces local event rates compared with ST and offers comparable PFS and CFPC-FS, with superior OS and CSS in the cRP arm compared to the ST arm in patients with o-mHSPC. However, there is a paucity of high-quality literature on this subject. Ongoing randomised controlled trials may soon clarify the role of cRP in the context of o-mHSPC concerning survival benefits. Full article
(This article belongs to the Special Issue Novel Advances in Surgery for Prostate Cancer)
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