Recognising the future leaders of Urologic Oncology is fundamental to safeguarding tomorrow's driving force in innovation. This collection will showcase the high-quality work of internationally recognized researchers in the early stages of their careers. We aim to highlight research by leading scientists of the future across the entire breadth of Urologic Oncology, and present advances in theory, experiment and methodology with applications to compelling problems. Please note, contributions to the collection are by invitation only. Please inform the Editorial Office at urology@frontiersin.org once you are prepared to submit. All Rising Star researchers will be suggested by established Editors within our board in recognition of their influence on the future directions in their respective fields. While future innovations in Urologic Oncology are yet to be discovered, this Research Topic will give us a hint at whom to follow.

Humanitas University

Servicio de Urología, Hospital Clínico San Carlos

Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital

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Frontiers in Urology

Urologic Oncology

Rising Stars in Urologic Oncology: 2023

Editorial: Rising stars in urologic oncology: 2023

The evolving landscape: magnetic resonance imaging in active surveillance for prostate cancer management

Urinary microbiome and urological cancers: a mini review

ObjectiveTo compare the association between previous local treatment modalities and the progression to castrate-resistant prostate cancer (CRCP) and overall survival (OS) in men with newly diagnosed metastatic prostate cancer.</sec>MethodsWe conducted a retrospective analysis using a nationwide, de-identified electronic health record (EHR)-derived database (Flatiron). Eligible patients had previously received radiation therapy (RT) or radical prostatectomy (RP) for their local disease, and had progressed to metastatic disease. Stratified Kaplan-Meier estimates by local treatment were used to measure OS from the date of metastasis diagnosis. Cox proportional models were used to test the association between prior local treatment, progression to CRPC, and death, after adjusting for patient-and disease-specific parameters. Also, we conducted a propensity score-matched analysis.</sec>ResultsOf the 1,338 patients who met the inclusion criteria, 46% underwent RP with or without adjuvant RT and 54% received RT. Median follow up for RP group and RT group were 38.6 months (32.6-45.4) and 26.0 months (I24.3-29.9), respectively. After adjusting for patient-and disease-specific parameters, the patients who received RT had a higher risk of developing CRPC than those in the RP group 1.36 [1.05-1.76]. After propensity score matching and adjusting for patient and disease-specific parameters, men who received RT had higher risk of death compared to their counterparts (HR:1.36, 95% CI:1.1-1.65, P= 0.003)</sec>ConclusionReal-world data suggest that patients with metastatic disease who had undergone prior RP might have a lower risk of developing a castrate-resistant state and improved OS compared to patients who had received RT. Significant amount of bias limits validity and strength of our findings. Whether type of local treatment influence the disease behavior remains open question and should be answered only within randomized trial.</sec>

Objective: To compare the association between previous local treatment modalities and the progression to castrate-resistant prostate cancer (CRCP) and overall survival (OS) in men with newly diagnosed metastatic prostate cancer.Methods: We conducted a retrospective analysis using a nationwide, de-identified electronic health record (EHR)-derived database (Flatiron). Eligible patients had previously received radiation therapy (RT) or radical prostatectomy (RP) for their local disease, and had progressed to metastatic disease. Stratified Kaplan-Meier estimates by local treatment were used to measure OS from the date of metastasis diagnosis. Cox proportional models were used to test the association between prior local treatment, progression to CRPC, and death, after adjusting for patient-and disease-specific parameters. Also, we conducted a propensity score-matched analysis.Results: Of the 1,338 patients who met the inclusion criteria, 46% underwent RP with or without adjuvant RT and 54% received RT. Median follow up for RP group and RT group were 38.6 months (32.6-45.4) and 26.0 months (I24.3-29.9), respectively. After adjusting for patient-and disease-specific parameters, the patients who received RT had a higher risk of developing CRPC than those in the RP group 1.36 [1.05-1.76]. After propensity score matching and adjusting for patient and disease-specific parameters, men who received RT had higher risk of death compared to their counterparts (HR:1.36, 95% CI:1.1-1.65, P= 0.003)Conclusion: Real-world data suggest that patients with metastatic disease who had undergone prior RP might have a lower risk of developing a castrate-resistant state and improved OS compared to patients who had received RT. Significant amount of bias limits validity and strength of our findings. Whether type of local treatment influence the disease behavior remains open question and should be answered only within randomized trial.

Comparative Analysis of Primary Prostate Cancer Treatment and Subsequent Metastatic Disease

Prostate cancer is the second most frequent cancer type among men globally. Herein, the roles of exosomes in prostate cancer tumorigenesis, progress along with metastasis were reviewed. Exosomes are small extracellular vesicles originated from the endosomal system then released to surrounding body fluids. They carry cargo comprising nucleic acids and proteins and deliver then to recipient cells and are implicated in cell-to-cell communications. They regulate the activities of recipient cells by modulating several physiological and pathological processes, such as remodeling the properties of the tumor microenvironment, modulating cancer metabolism and metastases, and regulating drug resistance. Tumor derived exosomes are present in various body fluids and their molecular profile can reflect the real-time status of the cancer cell. These characteristics make them prospective biologic signatures for diagnosis along with prognosis of different cancer types. Besides, exosomes have good biophysical properties, for instance high stability in the lipid bilayer membrane, as well as low immunogenicity which are key parameters for development of novel drug delivery approach.

Prostate cancer is the second most frequent cancer type among men globally. Herein, the roles of exosomes in prostate cancer tumorigenesis, progress along with metastasis were reviewed. Exosomes are small extracellular vesicles originated from the endosomal system then released to surrounding body fluids. They carry cargo comprising nucleic acids and proteins and deliver then to recipient cells and are implicated in cell-to-cell communications. They regulate the activities of recipient cells by modulating several physiological and pathological processes, such as remodeling the properties of the tumor microenvironment, modulating cancer metabolism and metastases, and regulating drug resistance. Tumor derived exosomes are present in various body fluids and their molecular profile can reflect the real-time status of the cancer cell. These characteristics make them prospective biologic signatures for diagnosis along with prognosis of different cancer types. Besides, exosomes have good biophysical properties, for instance high stability in the lipid bilayer membrane, as well as low immunogenicity which are key parameters for development of novel drug delivery approach.