Penile cancer is a rare malignancy, and multicenter data evaluating prognostic biomarkers in the Japanese population are limited. This study aimed to assess the prognostic significance of pretreatment blood-based biomarkers in patients with penile cancer.
We conducted a multicenter retrospective cohort study including 111 patients with penile cancer treated between January 2005 and December 2023 at ten institutions participating in the West Japan Uro-oncology Collaboration Group. Cancer-specific survival (CSS) was analyzed using the Kaplan-Meier method and Cox proportional hazards model. Receiver operating characteristic analyses were performed to determine optimal cutoff values for the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and squamous cell carcinoma antigen (SCC-Ag). A composite biomarker score was calculated based on the number of elevated biomarkers.
The 5-year overall survival and CSS rates were 71.1% and 77.4%, respectively. In univariate analyses, elevated PLR, elevated SCC-Ag, and higher composite biomarker scores were significantly associated with poorer CSS. In multivariate analysis, advanced clinical nodal status (≥ cN2) and distant metastasis (cM1) remained independent predictors of CSS, whereas blood-based biomarkers did not retain independent prognostic significance after adjustment for established clinicopathological factors. Kaplan-Meier analyses demonstrated significantly worse CSS in patients with high PLR, high SCC-Ag levels, and higher composite biomarker scores.
Pretreatment blood-based biomarkers, particularly PLR and SCC-Ag, are associated with prognosis in penile cancer. Although they did not retain independent prognostic factors after adjustment, these biomarkers may provide complementary prognostic information and help identify high-risk patients in clinical practice.
International journal of urology : official journal of the Japanese Urological Association. 2026 May [Epub]
Shuichi Tatarano, Makito Miyake, Yu Osaki, Kei Daizumoto, Koichiro Wada, Keita Kobayashi, Minoru Kato, Hideo Fukuhara, Takuya Tsujino, Kohei Kobatake, Rikiya Taoka, Junya Furukawa, Kohei Ogawa, Koji Shiraishi, Taisuke Matsue, Keiji Inoue, Ryoichi Maenosono, Yohei Sekino, Kiyohide Fujimoto, Hideki Enokida, West Japan Uro‐oncology Collaboration Group
Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan., Department of Urology, Nara Medical University, Kashihara, Japan., Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan., Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan., Department of Urology, Shimane University Faculty of Medicine, Izumo, Japan., Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan., Department of Urology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan., Department of Urology, Kochi Medical School, Nankoku, Kochi, Japan., Department of Urology, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Japan., Department of Urology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.