Urology Research & Practice

A systematic review of non-HPV prognostic biomarkers used in penile squamous cell carcinoma


Guy’s Campus, King’s College London School of Bioscience Education, London, UK


MRC Centre for Transplantation, Guy’s Hospital Campus, King’s College London, King’s Health Partners, London, UK


Division of Surgery and Interventional Science, University College London, London, UK


Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK


NIHR Biomedical Research Centre, University College London Hospital, London, UK


Department of Urology, King’s College Hospital, London, UK

Urol Res Pract 2021; 47: 358-365
DOI: 10.5152/tud.2021.21199
Read: 820 Downloads: 225 Published: 01 September 2021

The presence of lymph node metastasis is the most important prognostic indicator for patients with penile cancer. However, predicting which clinically node negative patients will harbor lymph node metastases remains unclear. The aim of this systematic review is to provide an overview of biomarkers p53, Ki-67, and SCCAg in predicting lymph node metastasis (LNM) and cancer-specific survival (CSS) in penile squamous cell carcinoma (SCC). MEDLINE, EMBASE, Cochrane Library, Scopus, and ClinicalTrials.gov were searched from inception until 15 October 2020. Eligible studies were identified by three independent reviewers. Outcome measures included the presence of penile LNM and CSS. Extracted data were narratively synthesized with GRADE criteria utilized to evaluate the quality of evidence. In total, 999 articles were screened with 20 selected for inclusion. Studies reporting the use of p53 to predict LNM and CSS were rated as having the highest quality of evidence using the GRADE criteria, and the majority showed a positive association between p53 expression and LNM and CSS. All biomarkers and outcome combinations had at least one study showing a significant effect on predicting the outcome. However, studies were heterogeneous, and many reported nonsignificant effects. Identifying p53 overexpression may help one to identify patients at higher risks of LNM to be considered for early inguinal lymphadenectomy. There is contradictory and unreliable evidence for the prognostic value of Ki-67 and SCCAg in penile SCC for LNM and CSS. Larger studies are required with more rigorous methods and reports to improve the evidence base.

Cite this article as: Bowie J, Singh S, O’Hanlon C, et al. A systematic review of non-HPV prognostic biomarkers used in penile squamous cell carcinoma. Turk J Urol. 2021; 47(5): 358-365

EISSN 2980-1478