Clinical implications of human papillomavirus genotype in cervical adeno-adenosquamous carcinoma
| Autor: | Mei Shan Jao, Yu Ruei Chen, Hsiu Ping Chang, Bruce Patsner, Chee-Jen Chang, Angel Chao, Chu Chun Huang, Yi-Ting Huang, Min Yu Chen, Cheng-Tao Lin, Tse Ching Chen, Jian Tai Qiu, Hung Hsueh Chou, Swei Hsueh, Shu Chen Chang, Jui Der Liou, Kuan Gen Huang, Chyong-Huey Lai, Chun-Chieh Wang, Ting-Chang Chang |
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| Rok vydání: | 2012 |
| Předmět: |
Oncology
Adult Cancer Research medicine.medical_specialty Genotype Adenosquamous carcinoma viruses medicine.medical_treatment Uterine Cervical Neoplasms Carcinoma Adenosquamous Internal medicine medicine Carcinoma Humans Stage (cooking) Prospective cohort study Papillomaviridae Survival analysis Aged Neoplasm Staging Gynecology Cervical cancer Aged 80 and over Human papillomavirus 16 Pelvic exenteration Human papillomavirus 18 business.industry Hazard ratio Middle Aged medicine.disease female genital diseases and pregnancy complications DNA Viral Multivariate Analysis Female business |
| Zdroj: | European journal of cancer (Oxford, England : 1990). 49(3) |
| ISSN: | 1879-0852 |
| Popis: | Background Our aims were to evaluate the genotype distribution of human papillomavirus (HPV) and the correlation between HPV parameters and clinicopathological/treatment variables with prognosis in cervical adeno-adenosquamous carcinoma (AD/ASC). Patients and methods Consecutive patients who received primary treatment for cervical AD/ASC International Federation of Gynecology and Obstetrics (FIGO) stages I–IV between 1993 and 2008 were retrospectively reviewed. Prognostic models were constructed and followed by internal validation with bootstrap resampling. Results A total of 456 AD/ASC patients were eligible for HPV genotyping, while 452 were eligible for survival analysis. HPV18 was detected in 51.5% and HPV16 in 36.2% of the samples. Age >50 years old, FIGO stages III–IV and HPV16-negativity were significantly related to cancer relapse, and age >50, FIGO stages III–IV, HPV16-negativity and HPV58-positivity were significant predictors for cancer-specific survival (CSS) by multivariate analyses. HPV16-positivity was also significantly associated with good prognosis in those receiving primary radiotherapy or concurrent chemoradiation (RT/CCRT) (CSS: hazard ratio 0.41, 95% confidence interval 0.21–0.78). Patients with FIGO stages I–II and HPV16-negative AD/ASC treated with primary RH-PLND had significantly better CSS (p Conclusions Age >50 years old, FIGO stages III–IV and HPV16-negativity were significant poor prognostic factors in cervical AD/ASC. Patients with HPV16-negative tumour might better be treated with primary surgery (e.g. radical hysterectomy for stages I–II and pelvic exenteration for stage IVA). Those with unresectable HPV16-negative tumour (stage IIIB) should undergo CCRT in combination with novel drugs. The inferences of a single-institutional retrospective study require prospective studies to confirm. |
| Databáze: | OpenAIRE |
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