Abstract
Background
Because of the low incidence of penile carcinoma (PC), the value of p16ink4a, p53, and human papilloma virus (HPV) infection status in clinical practice remains
unclear. Herein, we report our experience with potential clinical utility of these
markers in men with PC treated at our institution.
Patients and Methods
Tissue microarrays of 57 cases of invasive penile squamous cell carcinomas were immunohistochemically
stained for p16 and p53. HPV in situ hybridization (ISH) for high-risk subtypes was
also performed. Association between marker status, nodal disease, overall (OS) and
cancer-specific survival (CSS) were assessed.
Results
p16 and HPV ISH were positive in 23 (40%) and 24 (42%) of the cohort, respectively.
The proportion of warty, basaloid, or mixed warty basaloid tumor subtypes were significantly
greater in the p16-positive patients (48% vs. 3%; P < .01). p53 expression was negative in 31 (54%) cases. Only in p16-negative patients,
positive p53 status was associated with pN+ disease (odds ratio, 4.4 [95% confidence
interval (CI), 1.04-18.6]). In Kaplan–Meier analysis, the unadjusted estimated OS
was insignificantly longer in p16-positive patients (median OS, 75 vs. 27 months;
P = .27) and median CSS was not reached (P = .16). In a multivariable Cox proportional hazard model, when controlling for pathological
nodal status and adjuvant chemotherapy, p16 status was a significant predictor for
improved CSS (hazard ratio, 0.36 [95% CI, 0.13-0.99]). The worst CSS was seen in pN+
patients with double negative p16 and p53 expression (8 vs. 34 months; P = .01).
Conclusion
In this current cohort, p53 and p16 status showed clinical utility in predicting nodal
disease as well as survival.
Keywords
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Article info
Publication history
Published online: December 23, 2015
Accepted:
December 16,
2015
Received in revised form:
December 11,
2015
Received:
August 31,
2015
Identification
Copyright
© 2015 Elsevier Inc. All rights reserved.
