Editor’s Note: Urothelial carcinoma (UC) is a highly aggressive malignancy with high incidence and severe complications, significantly impacting patients’ quality of life and survival outcomes. In recent years, there have been remarkable advances in both the diagnosis and treatment of UC. At the 2025 Pujiang Uro-Oncology Conference—jointly organized by the CSCO Urothelial Carcinoma Expert Committee, CSCO Renal Cancer Expert Committee, the Chinese Urologic Oncology Cooperative Group, the Beijing Health Promotion Association Chen Jumei Public Welfare Foundation, and the Shanghai Urologic Oncology Institute, and co-organized by Fudan University Cancer Hospital—Professor Jinchun Xing of the First Affiliated Hospital of Xiamen University delivered an insightful lecture on the latest breakthroughs and future directions in UC management. Revolutionary Changes in UC Management
Oncology Frontier – Urology Frontier: What do you see as the most revolutionary changes in the field of UC in recent years? How have these breakthroughs improved patient care?
Professor Xing: This is indeed a key question. The treatment of UC is undergoing important breakthroughs. At this conference, teams led by Professor Dingwei Ye (Fudan University Cancer Hospital), Professor Zhuowei Liu (Sun Yat-sen University Cancer Center), and Professor Tianxin Lin (Fifth Affiliated Hospital of Sun Yat-sen University) presented exciting research findings.Of particular note, Professor Tianxin Lin’s team demonstrated that combining urine-based biomarker testing—such as methylation, DNA, or RNA assays—with large-scale computational models significantly improves both the specificity and sensitivity of UC diagnosis. These technologies are already progressing through regulatory approval processes in China and the United States, indicating that China has reached or is approaching a world-leading level in this domain. This represents a truly significant advance.In terms of treatment, China’s large patient base provides extensive surgical experience, and the technical standards for bladder cancer surgery are now on par with international levels. Significant progress has been made in robot-assisted laparoscopic procedures, open surgeries, and various types of urinary diversions, including ileal conduit, colonic conduit, and orthotopic neobladder reconstructions.Imaging diagnostics are also evolving rapidly. With the integration of artificial intelligence and advanced computational models, we are likely to see further breakthroughs. Traditional invasive cystoscopy may eventually be replaced by non-invasive or minimally invasive techniques. Urine biomarker testing combined with next-generation imaging technologies promises to significantly enhance diagnostic accuracy and patient comfort.In terms of therapeutic strategies, both domestic and international researchers are actively exploring innovative approaches. These include intravesical instillation therapies—such as BCG combined with monoclonal antibodies—and systemic immunotherapy combined with local immune interventions. Particularly in the field of high-risk non–muscle-invasive bladder cancer (NMIBC), China’s research progress is rapid and fully aligned with global standards.
Future Directions in UC Research and Management
Oncology Frontier – Urology Frontier: Looking ahead, what directions do you believe are most promising for future UC research and treatment?
Professor Xing: As I mentioned earlier, for more than a decade, major breakthroughs in UC diagnosis and treatment were limited. However, with advancements in bladder-preserving techniques and growing emphasis on quality of life, treatment paradigms are shifting. Radical cystectomy, while effective, is often associated with significant postoperative quality-of-life decline. The ultimate goal of cancer treatment is not only to prolong survival but also to ensure that patients live well. As such, bladder-preserving therapy is gradually becoming a preferred approach.Achieving the goal of bladder preservation places higher demands on diagnostic and therapeutic capabilities. First, we must continue to improve non-invasive diagnostic techniques, including urine-based biomarker testing and advanced imaging modalities. Second, we should promote the integration of comprehensive treatment strategies—combining curative local therapy, radiotherapy, neoadjuvant approaches, and adjuvant therapies. The scope of adjuvant treatments is expanding beyond traditional chemotherapy to include novel antibody–drug conjugates (ADCs) and immunotherapy, both of which are developing rapidly and will remain key areas of focus moving forward.
