The value of squamous cell carcinoma antigen in the prognostic evaluation, treatment monitoring and followup of patients with penile cancer.
OBJECTIVE
We examined whether squamous cell carcinoma antigen has significant value for prognostic evaluation, treatment monitoring and followup in patients with penile cancer.


METHODS
Serum squamous cell carcinoma antigen was prospectively measured in 63 patients with penile squamous cell carcinoma from 2005 to 2007. The normal range of squamous cell carcinoma antigen was set as less than 1.50 mug/l. Statistical data analysis was done by the nonparametric method. Survival analysis was performed with the log rank test and the Cox proportional hazard model.


RESULTS
Of all patients 23.8% had a value of squamous cell carcinoma antigen that was greater than the upper limit of normal. Increased values correlated positively with lymph node metastasis (p = 0.005). However, squamous cell carcinoma antigen could not accurately predict occult inguinal lymph node metastasis in clinically node negative cases. Preoperatively squamous cell carcinoma antigen was an independent prognostic factor for disease-free survival in patients with node positive penile cancer (OR 0.13, p = 0.006). Combining pretreatment squamous cell carcinoma antigen and the percent of decrease after surgery was informative for predicting disease recurrence. The prognostic value of squamous cell carcinoma antigen was also observed in a small number of patients treated with chemotherapy. During followup continuously increasing squamous cell carcinoma antigen indicated tumor progression without a significant lead time effect.


CONCLUSIONS
Squamous cell carcinoma antigen is not a sensitive marker of tumor burden. However, it has prognostic significance for disease-free survival in patients with penile cancer treated with surgery.
Zhu
Yao
Y
Department of Urology, Cancer Hospital and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Ye
Ding-Wei
DW
Yao
Xu-Dong
XD
Zhang
Shi-Lin
SL
Dai
Bo
B
Zhang
Hai-Liang
HL
Shen
Yi-Jun
YJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000235:genetics / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015843:Serpins / Q000235:genetics / Q000378:metabolism*; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015843:Serpins; C051072:squamous cell carcinoma-related antigen