Verification of HPV16 as a good prognostic factor for cervical adeno-adenosquamous carcinoma via an international collaborative study |
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| Affiliation: | 1. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University, Taoyuan, Taiwan;2. Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University, Taoyuan, Taiwan;3. Department of Obstetrics and Gynecology, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan;4. Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong, China;5. Clinical Trial Center, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan;6. Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan;7. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan;8. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung, Taiwan;9. Department of Obstetrics and Gynecology, Clinical Institute of Medicine and College of Medicine, National Cheng Kung University, Tainan, Taiwan;10. Department of Obstetrics and Gynecology, Yuan''s General Hospital, Kaohsiung, Taiwan;11. Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital and Chung Shan Medical University School of Medicine, Taichung, Taiwan;12. Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan |
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| Abstract: | ObjectiveThis study (Asian Gynecologic Oncology Group [AGOG]13-001/Taiwanese Gynecologic Oncology Group [TGOG]1006) was to validate human papillomavirus (HPV)16 as an independent good prognostic factor and investigate the impact of treatment modalities to cervical adenocarcinoma and adenosquamous carcinoma (AD/ASC).Materials and methodsPatients receiving primary treatment at AGOG and TGOG member hospitals for cervical AD/ASC were retrospectively (1993–2014) and prospectively (since 2014) enrolled. DNA extraction from paraffin-embedded tissue (FFPE) specimens was used for HPV genotyping. Those with suspected endometrial origin were excluded for analysis.ResultsA total of 354 patients with valid HPV results were enrolled, 287 (81.1%) of which had HPV-positive tumors. The top-3 types were HPV 18 (50.8%), HPV16 (22.9%) and HPV45 (4.0%). The HPV16-negativity rates varied widely across hospitals. 322 patients were eligible for prognostic analyses. By multivariate analysis, advanced stage (HR5.8, 95% confidence interval [CI] 2.1–15.8; HR5.8, 95% CI 1.6–20.5), lymph node metastasis (HR4.6, 95% CI 2.7–7.9; HR7.3, 95% CI 3.8–14.0), and HPV16-positivity (HR0.3, 95% CI 0.1–0.6; HR0.3, 95% CI 0.1–0.9) were independent prognostic factors for progression-free survival (PFS) and overall survival (OS). Stage I patients with primary surgery had better 5-year PFS (82.8% vs 50.0% p = 0.020) and OS (89.3% vs 57.1%, p = 0.017) than those with non-primary surgery, while the propensity scores distribution were similar among the treatment groups.ConclusionThis study confirmed that HPV16-positivity was a good prognostic factor for PFS and OS in AD/ASC, and patients seemed to have better outcome with primary surgery than non-primary surgery. |
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| Keywords: | Cervical cancer Cervical adenocarcinoma Cervical adenosquamous carcinoma Human papilloma virus HPV |
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