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KMID : 0358420140570060492
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Korean Journal of Obstetrics and Gynecology
2014 Volume.57 No. 6 p.492 ~ p.500
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Human papillomavirus 18 as a poor prognostic factor in stage I-IIA cervical cancer following primary surgical treatment
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Yang Sun-Hye
Kong Su-Kyoung
Lee Seung-Ho
Lim So-Yi
Park Chan-Yong
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Abstract
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Objective: This study evaluates the effect of the specific human papillomavirus (HPV) genotype as a prognostic factor in stage I-IIA cervical cancer patients following primary surgical treatment.
Methods: The medical records of 116 cervical cancer patients treated with primary surgical treatment were reviewed. The HPV genotypes were categorized into following groups: negative and unclassified, HPV 16, HPV 18, and other high risk (HPV 31, 33, 35, 45, 51, 52, 56, and 58).
Results: Among the HPV genotypes, HPV 16 predominated (40.52%), followed by intermediate risk and unclassified (25%), HPV 18, 45, and 56 (17.24%) and negative (17.24%). In univariate analysis, HPV genotypes (P=0.03), parametrial spread (P=0.02), depth of invasion (DOI) (P<0.01) and lymph-vascular space invasion (P=0.02) were significantly associated with progression free survival (PFS). In multivariate analysis, HPV 18 (hazard ratio [HR], 5.2; 95% confidence interval [CI], 1.29 to 20.90; P=0.02) and ≥one half of DOI (HR, 5.4; 95% CI, 1.08 to 27.31; P=0.04) were significantly associated with PFS. HPV genotypes are not significantly associated with overall survival.
Conclusion: HPV 18 was a poor prognostic factor for the PFS in stage I-IIA cervical cancer patients following primary surgical treatment. Careful long-term observation and regular exams are recommended for cervical cancer patients with HPV 18 compared to those with other HPV genotypes.
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KEYWORD
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Genotype, Human papillomavirus, Prognosis, Uterine cervical neoplasms
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