Development of a new outcome prediction model for Chinese patients with penile squamous cell carcinoma based on preoperative serum C-reactive protein, body mass index, and standard pathological risk factors: the TNCB score group system

// Zai-Shang Li 1,2,3,* , Peng Chen 4,* , Kai Yao 1,2,3,* , Bin Wang 5,* , Jing Li 5 , Qi-Wu Mi 6 , Xiao-Feng Chen 7 , Qi Zhao 8 , Yong-Hong Li 1,2,3 , Jie-Ping Chen 1,2,3 , Chuang-Zhong Deng 1,2,3 , Yun-Lin Ye 1,2,3 , Ming-Zhu Zhong 9 , Zhuo-Wei Liu 1,2,3 , Zi-Ke Qin 1,2,3 , Xiang-Tian Lin 10 , Wei-Cong Liang 10 , Hui Han 1,2,3 and Fang-Jian Zhou 1,2,3 1 Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China 2 State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China 3 Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China 4 Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumchi, P. R. China 5 Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, P. R. China 6 Department of Urology, Dong Guan People’s Hospital, Guang Dong, P. R. China 7 Department of Urology,The First People’s Hospital of Chenzhou, Chenzhou, P. R. China 8 School of Life Science, Sun Yat-sen University, School of Life Science, Guang Dong, P. R. China 9 Department of Urology, The People’s Hospital of Jiangmen, Jiangmen, P. R. China 10 Zhongshan School of Medicine, Sun Yat-sen University, Guang Dong, P. R. China * These authors have contributed equally to this work Correspondence to: Hui Han, email: // Fang-Jian Zhou, email: // Keywords : penile neoplasms, neoplasm staging, prognosis, body mass index, C-reactive protein Received : October 25, 2015 Accepted : January 24, 2016 Published : March 11, 2016 Abstract Purpose: To determine the predictive value and feasibility of the new outcome prediction model for Chinese patients with penile squamous cell carcinoma. Results: The 3-year disease-specific survival (DSS) was 92.3% in patients with < 8.70 mg/L CRP and 54.9% in those with elevated CRP ( P < 0.001). The 3-year DSS was 86.5% in patients with a BMI < 22.6 Kg/m2 and 69.9% in those with a higher BMI ( P = 0.025). In a multivariate analysis, pathological T stage ( P < 0.001), pathological N stage ( P = 0.002), BMI ( P = 0.002), and CRP ( P = 0.004) were independent predictors of DSS. A new scoring model was developed, consisting of BMI, CRP, and tumor T and N classification. In our study, we found that the addition of the above-mentioned parameters significantly increased the predictive accuracy of the system of the American Joint Committee on Cancer (AJCC) anatomic stage group. The accuracy of the new prediction category was verified. Methods: A total of 172 Chinese patients with penile squamous cell cancer were analyzed retrospectively between November 2005 and November 2014. Statistical data analysis was conducted using the nonparametric method. Survival analysis was performed with the log-rank test and the Cox proportional hazard model. Based on regression estimates of significant parameters in multivariate analysis, a new BMI-, CRP- and pathologic factors-based scoring model was developed to predict disease-specific outcomes. The predictive accuracy of the model was evaluated using the internal and external validation. Conclusion: The present study demonstrated that the TNCB score group system maybe a precise and easy to use tool for predicting outcomes in Chinese penile squamous cell carcinoma patients.