Cervical Cancer Outcomes Differ According to HPV Genotype

Last Updated: 2009-03-03 12:37:53 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Invasive cervical cancer outcomes are worse with high-risk human papillomavirus (HPV) genotypes than with intermediate-risk HPV genotypes, according to a report in the February 15th International Journal of Cancer.

"HPV genotypes 16 and 18 represent 70% of invasive carcinomas (this figure is to be kept in mind in the perspective of prophylactic anti HPV16/18 vaccination), and 4% of invasive carcinomas are HPV-negative (a figure to keep in mind in the perspective of screening intra-epithelial neoplasia via virological detection)," Dr. Xavier Sastre-Garau from Institut Curie, Paris, told Reuters Health.

Dr. Sastre-Garau and colleagues sought to define the HPV genotypes found in women with invasive carcinoma in France and to assess the prognostic value of the different HPV types.

The most prevalent genotypes found among the 515 women with invasive cervical cancer studied were HPV 16 (55.5%) and HPV 18 (14.2%), the authors report. A minority of women (4.1%) had no HPV DNA sequences.

Most women with squamous cell carcinoma had HPV 16 (59%), the report indicates, whereas more women with adenocarcinoma had HPV 18 (41%).

Women with HPV 18-associated tumors were younger than women with other genotypes, the researchers note, and high-risk HPV DNA sequences were found more commonly in tumors from premenopausal women than in tumors from postmenopausal women.

Five- and 10-year disease-free survivals were lower for women with high-risk HPV tumors (54.6% and 49.3%, respectively) than for women with intermediate-risk HPV tumors (66.7% and 59.6%), the investigators say.

In multivariate analyses, HPV status was a significant prognostic factor for disease-free survival but not for overall survival.

"The main aim of HPV typing in practice is to provide possible target for specific anti-HPV therapy in case of relapse," Dr. Sastre-Garau concluded. "Patients with HPV 16-associated tumor with relapse can be treated with specific anti-HPV 16 immunotherapy."

Int J Cancer 2009;124:778-782.


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