Prognosis of Human Papillomavirus–Negative Compared to Human Papillomavirus–Positive Cervical Cancer. Issue 2 (30th April 2022)

• Record Type: Journal Article
• Authors: Kugelman, Nir; Siegler, Efraim; Mackuli, Lena; Lavie, Ofer; Schmidt, Meirav; Shaked-Mishan, Pninit; Segev, Yakir
• Is Part Of: Journal of lower genital tract disease. Volume 26:Issue 2(2022)
• Page Start: 115
• Page End: 121
• Publication Date: 2022-04-30
• Subjects: human papillomavirus -- cervical cancer -- prognosis -- survival -- recurrence -- screening -- prevalence -- vaccination; Generative organs, Female -- Diseases -- Periodicals; Cervix uteri -- Diseases -- Periodicals; Generative organs -- Diseases -- Periodicals; Sexually transmitted diseases -- Periodicals; 618.1
• DOI: 10.1097/LGT.0000000000000650
• Languages: English
• ISSNs: 1089-2591

Abstract

Abstract : Objectives: The aims of the study were to evaluate the prevalence and prognosis of human papillomavirus (HPV)-negative cervical cancer (CC) and to compare these to data for HPV-positive CC. Materials and Methods: This retrospective cohort study compared between HPV-negative CC and HPV-positive CC patients. Primary end points were disease-free survival and overall survival. Secondary end points were demographic and clinical variables including histological diagnosis, stage, and treatment. Results: Of 233 women with CC, 18 (8%) tested HPV-negative. During a median follow-up of 45 months, 33 (14%) recurrences and 41 (18%) deaths were observed. Eleven of the 18 women (61%) who tested HPV-negative and 41 of the 215 (19%) who tested HPV-positive had only adenocarcinoma ( p < .001). In a multivariate logistic regression analysis, advanced age ( p = .003) and primary treatment with chemotherapy and/or radiotherapy ( p < .001) remained statistically significant for recurrence or mortality (disease-free survival). The factors associated with lower survival were advanced age ( p = .008), higher stage at diagnosis ( p < .001), and HPV negativity ( p = .062). Median overall survival for HPV-positive CC was not reached, compared with 24 months for HPV-negative CC. Kaplan-Meier curves showed lower rates of disease-free survival ( p = .008) and overall survival ( p = .011), for women with HPV-negative compared with HPV-positive CC. Conclusions: The relatively poor prognosis of HPV-negative CC is important in light of its relatively high prevalence, which could increase proportionally to HPV-positive CC due to increased HPV screening and vaccination. Further studies are needed to confirm whether HPV status is truly an independent prognostic factor in CC.