PMID: 40055816 https://pubmed.ncbi.nlm.nih.gov/40055816/

Abstract

BACKGROUND: C-reactive protein (CRP) is an essential biomarker for evaluating penile cancer prognosis. Previous studies have reported conflicting outcomes concerning the correlation between CRP levels and penile cancer prognosis. This study aimed to investigate this relationship by conducting a meta-analysis of published literature.

METHODS: A systematic literature search was conducted using the Cochrane Library, PubMed, and Embase databases to analyze the prognostic significance of serum CRP levels in individuals diagnosed with penile cancer. Pooled risk estimates were calculated using fixed-effects or random-effects models, depending on the degree of interstudy heterogeneity.

RESULTS: Sixty-eight articles were reviewed, identifying 8 articles and 989 patients that met the inclusion criteria for the meta-analysis. The pooled analysis revealed a significant association between serum CRP levels and adverse outcomes in penile cancer cases (hazard ratio [HR] = 2.37, 95% confidence interval [CI] = 1.46-3.858). Additional meta-analysis findings showed a negative correlation between elevated CRP levels and overall survival (HR = 1.97, 95% CI = 1.23-3.16, p<0.01), cancer-specific survival (HR = 3.42, 95% CI = 1.38-8.47, p<0.01), and disease-specific survival (HR = 3.23, 95% CI = 1.79-5.8, p<0.01) in patients with penile cancer. In the subgroup analysis, the HRs (95% CI) were 1.66 (0.61-4.48) in Europeans, 3.08 (2-4.74) in Asians, 3.04 (1.93-4. 77) in Chinese, 2.07 (1.21-3.53) in the group of cutoff value ≥ 5 mg/L, 2.43 (1.44-4.12) in the group of cutoff value ≥ 10 mg/L, 2.12 (1.04-4.32) in the group of surgical intervention, and 3.07 (1.76-5.37) in the group of multitherapy. This study also found a significant relationship between serum CRP levels and lymph node metastasis in patients with penile cancer (relative risk = 2.27, 95% CI = 1.61-3.2, p<0.01).

CONCLUSION: This meta-analysis indicates that increased CRP levels were associated with a poorer prognosis in penile cancer. Therefore, CRP levels could potentially serve as a prognostic indicator of penile cancer.