title: Elevated C-reactive protein values predict nodal metastasis in patients with penile cancer.
abstract: BACKGROUND
  The nodal status is a strong predictor for cancer specific death in patients with penile carcinoma, and the C-reactive protein (CRP) level at diagnosis has recently been shown to be associated with poor clinical outcome in various solid malignancies. Therefore, this retrospective study was performed to evaluate the association between preoperative CRP levels and the incidence of nodal metastasis in patients with squamous cell carcinoma (SCC) of the penis.
  
  
  METHODS
  The analysis included 51 penile cancer patients who underwent either radical or partial penectomy for pT1-4 penile cancer between 1990 and 2010. The nodal status was correlated with patient and tumor specific characteristics.
  
  
  RESULTS
  Sixteen (31%) patients had lymph node metastasis at the time of penile cancer surgery. Nodal status was associated with tumor stage but did not correlate significantly with tumor grade. In contrast, high presurgical CRP levels were significantly associated with the diagnosis of nodal involvement (p = 0.04). The optimal CRP cut-off value to predict lymph node metastasis was set at 20 mg/l based on ROC analysis.
  
  
  CONCLUSIONS
  Since a high preoperative serum CRP level was closely correlated with nodal disease, it could be used as an additional marker to help identify patients with penile cancer who may benefit from inguinal lymph node dissection.
authors.forename: Andreas
authors.initials: A
authors.lastname: Al Ghazal
authors.affiliation: Department of Urology, Hannover Medical School, Carl-Neuberg-Str, 1, D-30625 Hannover, Germany. steffens.sandra@mh-hannover.de.
authors.forename: Sandra
authors.initials: S
authors.lastname: Steffens
authors.forename: Julie
authors.initials: J
authors.lastname: Steinestel
authors.forename: Rieke
authors.initials: R
authors.lastname: Lehmann
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Schnoeller
authors.forename: Anna
authors.initials: A
authors.lastname: Schulte-Hostede
authors.forename: Gerd
authors.initials: G
authors.lastname: Wegener
authors.forename: Florian
authors.initials: F
authors.lastname: Jentzmik
authors.forename: Mark
authors.initials: M
authors.lastname: Schrader
authors.forename: Markus A
authors.initials: MA
authors.lastname: Kuczyk
authors.forename: Andres J
authors.initials: AJ
authors.lastname: Schrader
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality / Q000556:secondary*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000097:blood* / Q000401:mortality*; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein