Professor Dingwei Ye: A “Precision Breakthrough” in Prostate Cancer Prevention and Treatment in China | 2025 Pujiang Prostate Cancer Congress

Editor’s Note: As the tides of the Pujiang River surge forward, so too does China's momentum in prostate cancer innovation. The 2025 Pujiang Prostate Cancer Academic Congress—held jointly with the Annual Meeting of the CSCO Prostate Cancer Committee (CSCO-PC), the Prostate Cancer Conference of the CACA Genitourinary Oncology Committee (CACA-GO), and the Annual Conference of the Chinese Prostate Cancer Consortium (CPCC)—took place in Shanghai from June 27–28. The event gathered leading experts from China and abroad to exchange the latest advances and clinical practices in prostate cancer. In an exclusive interview with Oncology Frontier – Urology Frontier, Congress Chair and Professor Dingwei Ye of Fudan University Shanghai Cancer Center shared his perspectives on the current status and future of prostate cancer care in China, along with recent innovations in surgical treatment.

A Precision Breakthrough in Prostate Cancer Prevention and Care

Oncology Frontier – Urology Frontier: In your opening remarks, you mentioned that the 5-year survival rate for prostate cancer in China has improved from under 70% to 82.6%. However, this still lags behind rates in Western countries. You also introduced the concept of a “precision breakthrough.” How do you see precision strategies helping to improve long-term survival in China?

Prof. Dingwei Ye: Although the incidence of prostate cancer in China continues to rise, our 5-year survival rate still falls short of Western countries. For example, in the United States, it approaches or even exceeds 97%, while in China, it remains over 10 percentage points lower. To close this gap, we must harness advances in comprehensive and precision medicine tailored to our local context. I believe the path forward requires a “precision breakthrough” in the following areas:

Precision Early Detection Based on studies conducted among Chinese populations, we’ve developed screening strategies suited to Chinese men. These include more targeted risk stratification: PSA screening every two years is recommended for men over 50, those over 45 with a family history of prostate cancer, men over 40 with PSA levels >1 ng/mL, and BRCA2 mutation carriers aged over 40. These targeted efforts are expected to improve early detection and early intervention.

Precision Surgical Treatment For patients with localized early-stage disease, radical prostatectomy remains potentially curative. We now use robot-assisted radical prostatectomy (RARP), which allows for more precise tumor resection while preserving urinary continence and sexual function—achieving the dual goals of disease control and functional preservation.

Precision Multidisciplinary Care For patients with intermediate or advanced-stage disease, decision-making by a multidisciplinary team (MDT) is key to improving outcomes. Globally, MDT-based treatment is recognized as an effective way to improve cure rates and survival in solid tumors. In China, over 50% of prostate cancer patients—up to 60% in some regions—are diagnosed at later stages. For these patients, single-modality treatments are rarely sufficient. Instead, MDT-guided precision treatment—including cytoreductive surgery, precision medicine-based drug regimens, and stereotactic ablative body radiotherapy (SABR) for oligometastatic lesions—can help achieve survival outcomes comparable to those with localized disease.

Precision Clinical Trials Given China’s large and geographically diverse patient population, we must leverage this advantage to conduct impactful clinical research and accelerate the approval of domestically developed drugs and devices. At this year’s congress, we showcased Deutenzalutamide (HC-1119)—a deuterated AR antagonist independently developed in China—which may fill a critical treatment gap for Chinese patients.

With these precision strategies, we are confident in our ability to continue improving survival rates and narrowing the gap with the West.

Confronting the “Three Highs” in Chinese Prostate Cancer Patients

Oncology Frontier – Urology Frontier: At the conference, you delivered a keynote on the challenges of complex prostate cancer surgery. As a veteran urologist, could you share some key insights from your experience?

Prof. Dingwei Ye: In addition to the large number of cases and high incidence and mortality, prostate cancer in China is characterized by what I call the “three highs”:

Higher Age at Diagnosis – In China, the peak onset age for prostate cancer is later than in Western countries. While it’s around 65 in the U.S., in China it’s 70–75. As a result, a larger proportion of our patients are elderly.
Higher Proportion of High-Risk or Locally Advanced Disease – In the West, only about 5% of prostate cancer cases are metastatic or locally advanced at diagnosis. In China, that figure can reach 50–60%.
Higher Surgical Complexity – Due to the above, the proportion of complex surgical cases is significantly higher.

To manage elderly patients, age alone should not be considered a contraindication to surgery. What matters most is their physiological condition and expected survival. If a patient is likely to live another 10 years and can tolerate surgery, they should not be denied a curative procedure. For example, we successfully operated on an 86-year-old patient who recovered well and was discharged in good condition.

For high-risk patients, surgery alone is often not enough. We now combine robot-assisted surgery with precision imaging and (neo)adjuvant therapies during the perioperative period. This multidisciplinary approach significantly improves cure rates and overall survival.

To address complex surgical challenges, we’ve collaborated with domestic innovators to develop China’s first modular robotic surgical system—currently the third of its kind globally. It was approved two months ago by the National Medical Products Administration (NMPA). The modular robot is smaller, requires less surgical space, and costs less in terms of consumables—making it more accessible to hospitals in lower-tier cities. This breakthrough allows more patients to benefit from advanced robotic surgery, marking a step toward greater healthcare equity.

Domestically Developed Surgical Robots: Achieving a “Leap Ahead”

Oncology Frontier – Urology Frontier: Multiple domestically developed surgical robots are now being used in prostate cancer treatment. How can these systems be further optimized for the anatomical characteristics of Chinese patients, and what role do they play in expanding access to high-quality care?

Prof. Dingwei Ye: Radical prostatectomy is often regarded as the “crown jewel” of urologic surgery because it requires complete tumor removal and preservation of urinary continence and sexual function. This sets it apart from many other solid tumor surgeries. Additionally, PSA is an extremely sensitive postoperative indicator—if PSA doesn’t drop to nearly zero within 6 weeks, it suggests residual disease.

Robot-assisted radical prostatectomy is currently the best surgical approach for achieving all three treatment goals. However, it comes with significant costs. In Shanghai, for instance, consumables alone for a single surgery using an imported robotic system exceed ¥30,000, and the initial purchase price for the equipment can run into tens of millions of RMB. This is a heavy burden for hospitals, insurance providers, and patients alike.

The solution lies in domestic innovation. China has made remarkable progress in developing surgical robots that rival international counterparts. One such system we co-developed, Haisan No.1, is a modular robotic platform that competes with the integrated da Vinci system.

Key features of Haisan No.1 include:

Smaller Space Requirements: While da Vinci requires an 80 m² operating room, Haisan No.1 needs only 30 m².
Flexible Transport: Its modular design allows for easy relocation between operating rooms, enhancing utilization.
Lower Costs: As a domestically produced system, both acquisition and consumable costs are significantly reduced. It’s also compatible with existing laparoscopic imaging and instruments in hospitals.

By reducing costs across the board, Haisan No.1 lightens the financial burden on hospitals, insurance systems, and patients—making advanced surgical care more widely accessible and promoting the development of equitable healthcare in China.

The “Fudan Model” of MDT for Prostate Cancer

Oncology Frontier – Urology Frontier: Fudan’s approach to multidisciplinary care (MDT) is well recognized. How do you view the role of MDT in the full-course management of prostate cancer?

Prof. Dingwei Ye: Among all solid tumors, prostate cancer may be the best suited for multidisciplinary treatment. Internationally, MDT is widely regarded—and clinically validated—as one of the most effective approaches to improving cure and survival rates.

As discussed earlier, our “precision breakthrough” strategy requires full-course management. This includes precision screening and early diagnosis, curative surgery for early-stage cases, postoperative rehabilitation, and long-term follow-up and treatment for advanced cases. Coordinated use of various therapies also requires input from multiple specialties.

At Fudan University Shanghai Cancer Center, we’ve established disease-specific MDT teams for urologic and male reproductive cancers. These teams—led by urology and supported by oncology, radiology, pathology, and rehabilitation—are involved in every stage of treatment, particularly for patients with intermediate and advanced disease.

Thanks to this model of continuous, precision-driven multidisciplinary care, our 5-year survival rate for all prostate cancer patients has reached 82.6%. Among those treated with early curative surgery, the 5-year survival rate is 100%. These outcomes represent leading results within China and are comparable to international standards.

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