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In this Review, the authors discuss the novel concept of the prognostic role of prostate-specific membrane antigen (PSMA)–PET across all prostate cancer disease states in the context of established prognostic tools and describe the future directions of research on the prognostic value of PSMA–PET.

The use of nomograms for predicting tumor characteristics and outcomes in prostate cancer patients can be helpful in treatment decision-making. In this article the authors review several nomograms, developed since the observed stage migration in prostate cancer, that can be used to predict cancer prevalence at prostate biopsy, prognosis and pretreatment staging.

Despite considerable interest in focal therapy for patients with prostate cancer, no universally accepted criteria exist to identify candidates. A new study now suggests that accurate patient identification for focal therapy is not possible using conventional techniques. New tools are required to precisely characterize and localize tumors.

Quantum tunnelling of the magnetisation limits the performance of single-molecule magnets at low temperatures. Here, the authors combine ab initio and analytical methods to show that spin-phonon coupling subtly influences tunnelling via polaron formation.

This Review provides an overview of the main applications of single-port robotic surgery in urology, presenting emerging outcomes and discussing the transformative potential of this approach.

In this Review the authors explore the emerging role of HER2 in urothelial carcinoma, highlighting its biological and clinical significance, the challenges of using HER2 as a biomarker, and the variability and complexity of HER2 assessment. Evidence supporting HER2-targeted therapies and future directions for research and clinical applications are also discussed.

While it is known that localised prostate cancer is characterised by clonal heterogeneity, the clonal origin of synchronous lymph node (LN) metastases remains poorly understood. Here, the authors analyse the clonal origin of LN metastases in prostate cancer patients using multi-region sequencing.

Muscular Dystrophy can be caused by mutations in the dystrophingene, causing the severe Duchenne form or the mild Becker form depending on if the transcript is in or out-of-frame. Here the authors identify a Duchenne-type mutation that gives a Becker-like phenotype due to skipping of exon 45.

Recurrence of lupus nephritis after kidney transplantation is often regarded as rare, and transplantation of patients with end-stage renal disease secondary to this condition is common. Several studies, however, have reported a higher incidence of recurrence of lupusnephritis after renal transplantation than the 1–4% which is usually quoted. Weng and Goral discuss reasons for the variation in reported incidence of recurrent lupus nephritis and consider the potential clinical impact of recurrence.

Radiation therapy combined with androgen-deprivation therapy has become the standard-of-care treatment for patients with high-risk prostate cancer; however, superiority of this approach over other therapeutic options, such as surgery, has not been clearly demonstrated. This Review provides a comprehensive overview of the current status of surgery in the treatment of high-risk prostate cancer and highlights the findings that might underlie the increasing use of radical prostatectomy as the first-line treatment among patients with this disease.

Host proteins CPSF6, NUP153, and SEC24C are vital for HIV-1 infection. They bind to the viral capsid protein and contribute to shuttling of virions through the cytoplasm (SEC24C), import into the nucleus (NUP153 and CPSF6) and subsequent trafficking to preferred integration sites (CPSF6). Here, Wei et al. combine structural, biochemical and virological assays to emphasize the importance of prion-like low complexity domains surrounding short phenylalanine-glycine regions in binding and increasing the avidity when interacting with viral capsid.

Alternative splicing generates RNA isoforms that contribute to phenotypic diversity. Here the authors perform single-molecule full-length RNA sequencing to identify disease-associated variant transcript isoforms.

Dysregulation of ribonucleoprotein complex granules, previously implicated in neuromuscular disease, can drive pathogenesis in a genetic form of dilated cardiomyopathy, as shown in gene-edited pigs and patient-derived cardiomyocytes.

IL-23 produced by myeloid-derived suppressor cells regulates castration resistance in prostate cancer by sustaining androgen receptor signalling.

Pelvic lymph node dissection (PLND) has an important role in staging and therapy of prostate cancer, especially for high-risk disease. A novel tool has been proposed to correctly predict the probability of node-negative status after radical prostatectomy with PLND that could help postoperative decision making.

Imaging is critically important for the diagnosis and staging of patients with high-risk prostate cancer. While established prostate cancer staging guidelines have increased appropriate use of imaging, underuse for high-risk prostate cancer remains substantial. Several factors affect the utility of initial diagnostic imaging and, in this Review, Bjurlin and colleagues discuss the performance of conventional and emerging imaging modalities for diagnosing and staging high-risk prostate cancer.

The authors show that loss-of-interaction with the nuclear importer, TNPO3, causes cytoplasmic mislocalization of RBM20 variants linked to severe cases of dilated cardiomyopathy. Restoring their nuclear localization alleviates the disease phenotype.

High-risk prostate cancer includes a heterogeneous group of patients with a range of prognoses, with some that can be fatal. The optimal management of this patient subgroup is evolving. We critically evaluate the existing literature focused on defining the high-risk population, the management of patients with high-risk prostate cancer, and future directions to optimize care.

Erectile dysfunction following radical prostatectomy is common in men recovering from prostate cancer. The authors of this Review discuss the measures that can be taken to help preserve erectile function in men undergoing this surgery and approaches to treating men with postprostatectomy erectile dysfunction, including the concept of penile rehabilitation.

A joint panel from the American Urological Association (AUA) and the American Society for Radiation Oncology (ASTRO) have issued their recommendations for the use of postprostatectomy radiation therapy. Although these guidelines are urgently needed, the AUA–ASTRO panel has failed to consider some salient points and the guidelines ultimately remain of little help.

Mathieu et al. review current data on the effect of lymphovascular invasion on disease outcomes in patients with bladder cancer and assess its utility in informing clinical decision-making as a prognostic marker or indicator for early intervention.

MRI and the Vesical Imaging-Reporting And Data System are highly accurate imaging tools for bladder cancer staging. A panel of experts have agreed on their efficacy in different clinical settings for cancer care, using the Delphi methodology. This Expert Recommendation will provide guidance for future research agendas.