Survivin and Ki-67 Immunohistochemical Expression in Penile Squamous Cell Carcinoma: Clinicopathological Features and Overall Survival

Penile squamous cell carcinoma (PSCC) is rare but aggressive, with prognosis still largely determined by lymph node status. Reliable molecular biomarkers to guide follow-up and therapy are lacking. In our study from Southern Brazil, we evaluated two potential markers — Ki-67, a cell proliferation index, and Survivin, an inhibitor of apoptosis — in 35 patients treated surgically for PSCC.

Ki-67 was positive in 42.8% of cases but showed no significant association with survival. Survivin, however, told a different story: patients with Survivin-positive tumors had dramatically worse 5-year overall survival (12.5% vs. 71.8%; HR 3.73, p=0.01).

Survivin’s selective expression in cancer cells and its role in tumor progression make it a promising candidate for both prognostic assessment and targeted therapy. Early-phase research in other cancers suggests Survivin inhibition may enhance sensitivity to chemotherapy, radiotherapy, and even immune checkpoint inhibitors — a potential game-changer for advanced PSCC, where treatment options are limited.

While our findings require validation in larger, HPV-stratified cohorts, Survivin could become a valuable tool for identifying high-risk patients and personalizing treatment strategies in PSCC.

Written by: Iago Z. Pires, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil

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