Gynecology
Human papillomavirus deoxyribonucleic acid as a prognostic indicator in early-stage cervical cancer: A possible role for type 18

https://doi.org/10.1016/0002-9378(95)90633-9Get rights and content

Abstract

OBJECTIVE: Our purpose was to determine the prognostic significance of human papillomarivus deoxyribonucleic acid in cervical cancers.

STUDY DESIGN: The polymerase chain reaction was used to detect human papillomavirus deoxyribonucleic acid types 6, 11, 16, 18, 31, 33, 52, or 58 in tumors from 148 patients (equal numbers of whom were disease free or had relapses) surgically treated for stage IIB or IIA cancers in a major Australian hospital. Cox regression modeling was used to assess the effect of human papillomavirus status on tumor recurrence, taking into account patient age, clinical stage, histologic node status, and type of tumor.

RESULTS: Seventy of 74 (95%) of the recurring tumors and 62 of 74 (84%) of the nonrecurring tumors were human papillomavirus deoxyribonucleic acid positive. The rates of positivity of types 16 and 18 were 64% versus 31% in the recurrers and 65% versus 14% in the nonrecurrers. Human papillomavirus type 18 positivity was associated with a greater risk of recurrence than was type 16 positivity (hazard ratio 1.8; p = 0.03). Clinical stage, nodal metastasis, and young age (≤ 35 years) also had adverse effects on relapse (hazard ratio for each approximately 2).

CONCLUSION: Human papillomavirus type 16 positivity is a risk factor for tumor recurrence in surgically treated cervical cancer.

References (25)

  • SK Kjaer et al.

    Comparison studies of HPV detection in areas at different risk for cervical cancer

  • J Walker et al.

    Human papillomavirus genotype as a prognostic indicator in carcinoma of the uterine cervix

    Obstet Gynecol

    (1989)
  • Cited by (50)

    • Human papillomavirus genotype and prognosis of cervical cancer: Favorable survival of patients with HPV16-positive tumors

      2018, Papillomavirus Research
      Citation Excerpt :

      The current study showed stage-specific results, with the favorable survival effect of HPV16 positivity restricted to FIGO stage III/IV tumors. However, several studies have reported significant associations between HPV18 detection and poor prognosis in early-stage ICC [6,7,11], suggesting rapid spread of HPV18-positive tumors during the early stage. Given that few patients with FIGO stage I/II tumors died from the disease in the present study, our sample size may have been too small to detect any slight differences in survival among early-stage tumors with different HPV genotypes.

    • Poor prognosis associated with human papillomavirus α7 genotypes in cervical carcinoma cannot be explained by intrinsic radiosensitivity

      2013, International Journal of Radiation Oncology Biology Physics
      Citation Excerpt :

      The oncogenic HPV types can be classified phylogenetically according to L1 protein sequence homology into α9 (HPV16, -31, -33, -35, -52, -58, and -67) and α7 (HPV18, -39, -45, -59, -68, and -70) classes (5). Several studies have shown HPV18-associated cervical cancer to have a poorer outcome after primary surgery than HPV16-positive tumors and that prognostic significance is retained in multivariate analysis (6-8). For example, in a study of 171 patients with stage Ib-IIa disease who received radical hysterectomy and lymphadenectomy, HPV18 tumors had a poorer prognosis compared with HPV16 in multivariate analysis (hazard ratio [HR] 2.59, 95% confidence interval [CI] 1.08-6.22) (8).

    • HPV-18 is a poor prognostic factor, unlike the HPV viral load, in patients with stage IB-IIA cervical cancer undergoing radical hysterectomy

      2011, Gynecologic Oncology
      Citation Excerpt :

      The following factors have been identified as predictors of survival: lymph node metastasis, primary tumor size, depth of stromal invasion, the presence or absence of LVSI, parametrial invasion, histologic cell type, and the status of the vaginal margins [7]. The relationship between HPV genotype to prognosis of early-stage invasive cervical cancer is controversial [11–15]. It has been reported that HPV-18-positive tumors are associated with a poorer prognosis [11–13].

    • Clinical effect of human papillomavirus genotypes in patients with cervical cancer undergoing primary radiotherapy

      2010, International Journal of Radiation Oncology Biology Physics
      Citation Excerpt :

      The presence of HPV DNA has been shown to be essential for the development of invasive cervical cancer (1, 2). However, contradictory results have been presented concerning the influence of HPV genotypes on the clinical outcome of cervical cancer patients (6–9, 11–14, 20). The present study with a large population (1,010 patients) and long-term follow-up (median, 78 months) has illustrated the significant clinical effect of HPV genotypes in cervical cancer patients undergoing primary RT.

    • How much cervical cancer in Australia is vaccine preventable? A meta-analysis

      2008, Vaccine
      Citation Excerpt :

      Eight studies were excluded (some for more than one reason): seven did not use PCR [23–30], four had too few specimens [23–25,31] and one only tested for HPV16 [32,33]. Five studies were used to assess type specific HPV prevalence in cervical cancers [21,34–37] giving a total of 553 cancers. The study of Chen [38] was not included, as the same specimens have been re-typed in the study of Stevens [21].

    View all citing articles on Scopus

    Supported by the National Health and Medical Research Council of Australia and the Royal Prince Alfred Hospital Cancer Research Fund.

    View full text