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Recently, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi mathvariant=\"normal\">P<\/mml:mi><mml:msup><mml:mrow><mml:mn mathvariant=\"normal\">16<\/mml:mn><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">I<\/mml:mi><mml:mi mathvariant=\"normal\">N<\/mml:mi><mml:mi mathvariant=\"normal\">K<\/mml:mi><mml:mn mathvariant=\"normal\">4<\/mml:mn><mml:mi mathvariant=\"normal\">a<\/mml:mi><\/mml:mrow><\/mml:msup><\/mml:math> expression has been shown to be correlated with cancer-specific survival (CSS) in penile squamous cell carcinoma (SCC). Therefore, we performed this meta-analysis to clarify the prognostic value of <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi mathvariant=\"normal\">P<\/mml:mi><mml:msup><mml:mrow><mml:mn mathvariant=\"normal\">16<\/mml:mn><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">I<\/mml:mi><mml:mi mathvariant=\"normal\">N<\/mml:mi><mml:mi mathvariant=\"normal\">K<\/mml:mi><mml:mn mathvariant=\"normal\">4<\/mml:mn><mml:mi mathvariant=\"normal\">a<\/mml:mi><\/mml:mrow><\/mml:msup><\/mml:math> for penile SCC.<jats:italic> Methods<\/jats:italic>. A systematic search was performed in PubMed, Embase, and Web of Science to identify all relevant articles up to May 25, 2017. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of included studies were pooled to estimate the prognostic value. Trial sequential analysis (TSA) was performed to assess the quantity and strength of survival evidence.<jats:italic> Results<\/jats:italic>. Five retrospective studies consisting of 323 cases were finally included. We found that <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi mathvariant=\"normal\">P<\/mml:mi><mml:msup><mml:mrow><mml:mn mathvariant=\"normal\">16<\/mml:mn><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">I<\/mml:mi><mml:mi mathvariant=\"normal\">N<\/mml:mi><mml:mi mathvariant=\"normal\">K<\/mml:mi><mml:mn mathvariant=\"normal\">4<\/mml:mn><mml:mi mathvariant=\"normal\">a<\/mml:mi><\/mml:mrow><\/mml:msup><\/mml:math> positive expression was significantly associated with a better CSS of penile SCC (HR=0.45, 95%CI: 0.30-0.67, P&lt;0.001). No heterogeneity or publication bias was noted among the included studies. Furthermore, TSA demonstrated that the findings were based on sufficient evidence.<jats:italic> Conclusions<\/jats:italic>. <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi mathvariant=\"normal\">P<\/mml:mi><mml:msup><mml:mrow><mml:mn mathvariant=\"normal\">16<\/mml:mn><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">I<\/mml:mi><mml:mi mathvariant=\"normal\">N<\/mml:mi><mml:mi mathvariant=\"normal\">K<\/mml:mi><mml:mn mathvariant=\"normal\">4<\/mml:mn><mml:mi mathvariant=\"normal\">a<\/mml:mi><\/mml:mrow><\/mml:msup><\/mml:math> positive expression is independently associated with improved CSS for patients with penile SCC.<\/jats:p>","DOI":"10.1155\/2018\/8345893","type":"journal-article","created":{"date-parts":[[2018,7,19]],"date-time":"2018-07-19T23:42:49Z","timestamp":1532043769000},"page":"1-9","source":"Crossref","is-referenced-by-count":8,"title":["Prognostic Significance of <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi mathvariant=\"normal\">P<\/mml:mi><mml:msup><mml:mrow><mml:mn mathvariant=\"normal\">16<\/mml:mn><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">I<\/mml:mi><mml:mi mathvariant=\"normal\">N<\/mml:mi><mml:mi mathvariant=\"normal\">K<\/mml:mi><mml:mn mathvariant=\"normal\">4<\/mml:mn><mml:mi mathvariant=\"normal\">a<\/mml:mi><\/mml:mrow><\/mml:msup><\/mml:math> Expression in Penile Squamous Cell Carcinoma: A Meta-Analysis with Trial Sequential Analysis"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8579-7754","authenticated-orcid":true,"given":"Jiayi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2562-1247","authenticated-orcid":true,"given":"Hengcheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8278-2477","authenticated-orcid":true,"given":"Yanyan","family":"Xiu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6341-541X","authenticated-orcid":true,"given":"Hong","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0589-7246","authenticated-orcid":true,"given":"Min","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4963-4912","authenticated-orcid":true,"given":"Ninghong","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2011.12.048"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2008.063149"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2010.04.007"},{"issue":"4","key":"4","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/s10552-008-9276-9","volume":"20","year":"2009","journal-title":"Cancer Causes & Control : 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