The value of squamous cell carcinoma antigen in the prognostic evaluation, treatment monitoring and followup of patients with penile cancer.

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

MATERIALS AND 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.