p16 INK4a is a Marker of Good Prognosis for Primary Invasive Penile Squamous Cell Carcinoma: A Multi-Institutional Study

No AccessJournal of UrologyAdult Urology1 Mar 2012p16INK4a is a Marker of Good Prognosis for Primary Invasive Penile Squamous Cell Carcinoma: A Multi-Institutional Study Sven Gunia, Andreas Erbersdobler, Oliver W. Hakenberg, Stefan Koch, and Matthias May Sven GuniaSven Gunia Institute of Pathology, HELIOS Clinic Bad Saarow, Bad Saarow, Germany , Andreas ErbersdoblerAndreas Erbersdobler Institute of Pathology, University of Rostock, Rostock, Germany Department of Urology, University of Rostock, Rostock, Germany , Oliver W. HakenbergOliver W. Hakenberg Department of Urology, University of Rostock, Rostock, Germany , Stefan KochStefan Koch Institute of Pathology, HELIOS Clinic Bad Saarow, Bad Saarow, Germany , and Matthias MayMatthias May Department of Urology, St. Elisabeth Clinic Straubing, Straubing, Germany View All Author Informationhttps://doi.org/10.1016/j.juro.2011.10.149AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the prognostic role of p16INK4a expression in penile cancer with respect to cancer specific survival. Materials and Methods: Based on a multi-institutional collaboration wax embedded tissues from 92 surgically treated patients, including 27 with total and 65 with partial penectomy, were retrospectively evaluated. After a central histopathological review by 1 pathologist a tissue microarray was constructed for p16INK4a immunostaining. Two independent pathologists evaluated p16INK4a expression, which was correlated with cancer specific survival. The κ statistic was used to assess interobserver variability. Univariate and multivariate Cox proportional hazards analysis was applied to assess the independent effects of prognostic factors on cancer specific survival during a median postoperative followup of 32 months (IQR 6–66). Results: The κ statistic revealed excellent interobserver agreement (κ 0.934, p <0.001). Two and 5-year cancer specific survival rates for the entire study cohort were 86% and 74%, respectively. The 2 and 5-year rates for patients without and with p16INK4a expression differed significantly (73% and 57% vs 95% and 85%, respectively, p = 0.011). Univariate analysis revealed p16INK4a expression as a significant prognostic factor with respect to cancer specific survival (p = 0.018). Multivariate analysis identified koilocytosis (HR 0.24, 95% CI 0.07–0.83, p = 0.024), p16INK4a expression (HR 0.44, 95% CI 0.23–0.84, p = 0.013), and histological stage (HR 3.54, 95% CI 1.88–6.67, p <0.001) and grade (HR 2.47, 95% CI 1.00–6.09, p = 0.049) as independent prognostic factors for cancer specific survival. Conclusions: Results show that p16INK4a seems to be a prognostic parameter for primary invasive penile cancer with excellent interobserver reproducibility. At pathology laboratories without antibodies against p16INK4a conventional histological determination of koilocytosis by the pathologist also appears to provide important prognostic information for cancer specific survival. References 1 : How accurate are present risk group assignment tools in penile cancer?. World J Urol2009; 27: 155. Google Scholar 2 : Nomogram predictive of cancer specific survival in patients undergoing partial or total amputation for squamous cell carcinoma of the penis. J Urol2006; 175: 2103. 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Link, Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHartz J, Engelmann D, Fürst K, Marquardt S, Spitschak A, Goody D, Protzel C, Hakenberg O and Pützer B (2016) Integrated Loss of miR-1/miR-101/miR-204 Discriminates Metastatic from Nonmetastatic Penile Carcinomas and Can Predict Patient OutcomeJournal of Urology, VOL. 196, NO. 2, (570-578), Online publication date: 1-Aug-2016.Tang D, Clark P, Giannico G, Hameed O, Chang S and Gellert L (2014) Lack of P16ink4a Over Expression in Penile Squamous Cell Carcinoma is Associated with Recurrence after Lymph Node DissectionJournal of Urology, VOL. 193, NO. 2, (519-525), Online publication date: 1-Feb-2015. Volume 187Issue 3March 2012Page: 899-907 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordscyclin-dependent kinase inhibitor p16penismortalitycarcinomaprognosissquamous cellAcknowledgmentsDrs. V. Henn, Department of Pathology, Ruppiner Clinics, Neuruppin; J. Jander, Department of Pathology, Rhön Clinic Frankfurt/Oder, Frankfurt/Oder; H. Lobeck, Department of Pathology, Ernst-von-Bergmann Clinic Potsdam, Potsdam; and R. Pauli, Department of Pathology, Health Care Centre Brandenburg an der Havel, Brandenburg an der Havel; and M. Tuffaha, Carl-Thiem Clinic Cottbus, Cottbus, Germany, provided archival wax embedded tissue.MetricsAuthor Information Sven Gunia Institute of Pathology, HELIOS Clinic Bad Saarow, Bad Saarow, Germany More articles by this author Andreas Erbersdobler Institute of Pathology, University of Rostock, Rostock, Germany Department of Urology, University of Rostock, Rostock, Germany More articles by this author Oliver W. Hakenberg Department of Urology, University of Rostock, Rostock, Germany More articles by this author Stefan Koch Institute of Pathology, HELIOS Clinic Bad Saarow, Bad Saarow, Germany More articles by this author Matthias May Department of Urology, St. Elisabeth Clinic Straubing, Straubing, Germany More articles by this author Expand All Advertisement PDF downloadLoading ...