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The Prognostic Role of Human Papillomavirus in Patients With Vaginal Cancer
  1. Andreas H. Brunner, MD*,,
  2. Christoph Grimm, MD*,
  3. Stephan Polterauer, MD*,
  4. Lukas Hefler, MD*,
  5. Josefine Stani, PhD,
  6. Georg Heinze, PhD§ and
  7. Reinhard Horvat, MD
  1. *Department of Obstetrics and Gynaecology, Medical University of Vienna;
  2. Department of Obstetrics and Gynaecology, Landesklinikum Thermenregion Moedling, Moedling;
  3. Department of Pathology, Medical University of Vienna; and
  4. §Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
  1. Address correspondence and reprint requests to Andreas H. Brunner, MD, Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. E-mail: dr.andreas.brunner{at}


Objective: The objective of the study was to evaluate the association between human papillomavirus (HPV) infection and clinical-pathological parameters in primary squamous cell carcinoma of the vagina and assess the value of HPV infection as a prognostic parameter.

Methods: In our retrospective study, we identified 37 consecutive patients with primary invasive squamous cell carcinoma of the vagina; 35 patients were eligible for further investigations. Human papillomavirus detection was assessed by in situ hybridization assays from paraffin-embedded tissue blocks. Human papillomavirus detection was correlated with clinical-pathological parameters by χ2 and Fisher exact tests. Univariate log-rank tests and multivariate Cox regression models were used to evaluate the association between HPV infection and patient survival.

Results: Human papillomavirus DNA was detected in 18 (51.4%) of 35 cases. Human papillomavirus status did no influence clinical-pathological parameters, such as clinical stage (P = 0.9), grade (P = 0.9), and tumor size (P = 0.18). Prognosis did not significantly differ between HPV-positive and HPV-negative tumors in the entire cohort; however, patients with unfavorable tumor stage (International Federation of Gynecology and Obstetrics stage ≥III) and HPV positivity had improved disease-free (P = 0.004) and overall survival (P = 0.023).

Conclusions: Human papillomavirus infection was frequently detected in squamous cell carcinoma of the vagina, and its presence may serve as a prognostic indicator in advanced stages.

  • HPV
  • Prognosis
  • Squamous cell cancer
  • Vaginal cancer

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  • There was no outside funding or technical assistance with the production of this article.