Introduction/Background*To evaluate the prevalence and prognosis of human papillomavirus (HPV)-negative cervical cancer (CC), and compare these to data for HPV-positive CC.
Methodology This retrospective cohort study compared between HPV-negative CC and HPV-positive CC patients. Primary endpoints were recurrence-free survival, disease-free survival, and overall survival. Secondary endpoints were demographic and clinical variables including histological diagnosis, stage, and treatment.
Result(s)*Of 233 women with CC, 18 (8%) were HPV negative. During a median follow up of 45 months, 33 (14%) recurrences and 41 (18%) deaths were observed. Eleven (61%) of the 18 women who were HPV negative and 41 (19%) of the 215 who were HPV positive had only adenocarcinoma (P<0.001). In a multivariate logistic regression analysis, adenocarcinoma histology at diagnosis (P=0.010) and primary treatment with chemotherapy or radiotherapy (P=0.011) remained statistically significant for recurrence. The factors associated with lower survival were advanced age (P=0.008), higher stage at diagnosis (P<0.001) and HPV negativity (P=0.062). Median overall survival for HPV-positive CC was not reached, compared to 24 months for HPV-negative CC. Kaplan-Meier curves showed lower rates of overall survival (P=0.011), recurrence-free survival (P=0.005) and disease-free survival (P=0.008) for women with HPV-negative compared to HPV-positive CC.
Conclusion*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 if HPV status is truly an independent prognostic factor in CC.
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