Bedeutung von HPV-Status und p16 für die Prognose des Peniskarzinoms

Mink JN, Khalmurzaev O, Pryalukhin A, Hölters S, Geppert CI, Lohse S, Bende K, Lobo J, Henrique R, Loertzer H, Steffens J, Jerónimo C, Wunderlich H, Heinzelbecker J, Bohle R, Stöckle M, Matveev V, Hartmann A, Junker K (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Aktuelle Urologie Georg Thieme Verlag

Book Volume: 54

Pages Range: 274-284

Journal Issue: 4

DOI: 10.1055/a-2104-1270

Abstract

BACKGROUND: Penile cancer is a rare but often lethal tumour disease, especially in the metastatic stage. Most data on prognostic factors for penile cancer are based on small patient cohorts, and even meta-analyses are mostly limited in terms of patient numbers. There is a lack of sufficient parameters to predict the metastatic risk of these tumours. Furthermore, the role of the HPV status for the prognosis, and, in this regard, of p16INK4a is still unclear. MATERIAL AND METHODS: In this study, 236 patients from an international multicentre cohort were analysed with regard to histological subtypes, HPV and p16 status, and other clinical parameters. The HPV status was only graded as HPV-positive if HPV was detected by PCR and the p16 status defined by immunochemistry was positive. The statistical analysis was carried out using the Kaplan-Meier method as well as the log-rank test and a univariable and multivariable analysis using the Cox regression model. RESULTS: A positive HPV status was not a significant parameter for either metastasis-free (MFS), tumour-specific (CSS) or overall survival (OS). p16-positive tumours showed a significantly better MFS (p=0.026), which was also confirmed in the subgroup analysis of HPV-negative tumours (p=0.037) without differences in CSS or OS. In the usual type, there was also a trend towards an improved MFS, but without statistical significance (p=0.070). p16-positive tumours were associated with a highly significantly better MFS (hazard ratio 0.3; p=0.004) in the multivariable Cox regression, while patients with a pT1b tumour stage or advanced lymph node metastasis showed a significantly worse survival. In the multivariable analysis of HPV-negative tumours, p16 status was also confirmed as an independent predictor of MFS (Hazard ratio 0.2; p=0.007). CONCLUSION: HPV status alone seems to be lacking prognostic relevance. In contrast, p16 status was confirmed as an independent prognostic factor. Thus, the expression of p16INK4a is associated with a significantly better MFS. Especially in HPV-negative tumours, the p16 status should be evaluated with regard to the prognostic value and thus also with a view to the treatment decision.

Authors with CRIS profile

Carol-Immanuel Geppert Institute of Pathology Kristóf Bende Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Arndt Hartmann Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie

Involved external institutions

Instituto Português de Oncologia do Porto FG, EPE (IPO-Porto) PT Portugal (PT) Universität des Saarlandes (UdS) DE Germany (DE) St. Georg Klinikum Eisenach gemeinnützige GmbH DE Germany (DE) N.N. Blokhin Russian Cancer Research Center / Российский онкологический научный центр им. Н. Н. Блохина RU Russian Federation (RU) Westpfalz-Klinikum DE Germany (DE)

How to cite

APA:

Mink, J.N., Khalmurzaev, O., Pryalukhin, A., Hölters, S., Geppert, C.-I., Lohse, S.,... Junker, K. (2023). Bedeutung von HPV-Status und p16 für die Prognose des Peniskarzinoms. Aktuelle Urologie, 54(4), 274-284. https://dx.doi.org/10.1055/a-2104-1270

MLA:

Mink, Jan Niklas, et al. "Bedeutung von HPV-Status und p16 für die Prognose des Peniskarzinoms." Aktuelle Urologie 54.4 (2023): 274-284.

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