title: High CRP values predict poor survival in patients with penile cancer.
abstract: BACKGROUND
  High levels of circulating C-reactive protein (CRP) have recently been linked to poor clinical outcome in various malignancies. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP level in patients with squamous cell carcinoma (SCC) of the penis.
  
  
  METHODS
  This retrospective analysis included 79 penile cancer patients with information about their serum CRP value prior to surgery who underwent either radical or partial penectomy at two German high-volume centers (Ulm University Medical Center and Hannover Medical School) between 1990 and 2010. They had a median (mean) follow-up of 23 (32) months.
  
  
  RESULTS
  A significantly elevated CRP level (>15 vs. ≤ 15 mg/l) was found more often in patients with an advanced tumor stage (≥pT2) (38.9 vs. 11.6%, p=0.007) and in those with nodal disease at diagnosis (50.0 vs. 14.6%, p=0.007). However, high CRP levels were not associated with tumor differentiation (p=0.53). The Kaplan-Meier 5-year cancer-specific survival (CSS) rate was 38.9% for patients with preoperative CRP levels above 15 mg/l and 84.3% for those with lower levels (p=0.001). Applying multivariate analysis and focusing on the subgroup of patients without metastasis at the time of penile surgery, both advanced local tumor stage (≥pT2; HR 8.8, p=0.041) and an elevated CRP value (>15 mg/l; HR 3.3, p=0.043) were identified as independent predictors of poor clinical outcome in patients with penile cancer.
  
  
  CONCLUSIONS
  A high preoperative serum CRP level was associated with poor survival in patients with penile cancer. If larger patient populations confirm its prognostic value, its routine use could enable better risk stratification and risk-adjusted follow-up of patients with SCC of the penis.
authors: Department of Urology, Hannover Medical School, Hannover, Germany. steffens.sandra@mh-hannover.de
authors: Sandra
authors: S
authors: Steffens
authors: Andreas
authors: A
authors: Al Ghazal
authors: Julie
authors: J
authors: Steinestel
authors: Rieke
authors: R
authors: Lehmann
authors: Gerd
authors: G
authors: Wegener
authors: Thomas J
authors: TJ
authors: Schnoeller
authors: Marcus V
authors: MV
authors: Cronauer
authors: Florian
authors: F
authors: Jentzmik
authors: Mark
authors: M
authors: Schrader
authors: Markus A
authors: MA
authors: Kuczyk
authors: Andres J
authors: AJ
authors: Schrader
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000556:secondary* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D057234:Preoperative Period; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein
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