Clinical implications of human papillomavirus genotype in cervical adeno-adenosquamous carcinoma

Chyong Huey Lai, Hung Hsueh Chou, Chee Jen Chang, Chun Chieh Wang, Swei Hsueh, Yi Ting Huang, Yu Ruei Chen, Hsiu Ping Chang, Shu Chen Chang, Cheng Tao Lin, Angel Chao, Jian Tai Qiu, Kuan Gen Huang, Tse Ching Chen, Mei Shan Jao, Min Yu Chen, Jui Der Liou, Chu Chun Huang, Ting Chang Chang, Bruce Patsner

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


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 < 0.0001) than those treated with RT/CCRT. 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.

Original languageEnglish
Pages (from-to)633-641
Number of pages9
JournalEuropean Journal of Cancer
Issue number3
Publication statusPublished - Feb 2013
Externally publishedYes


  • Adenocarcinoma
  • Cervical cancer
  • Genotype
  • Human papillomavirus
  • Prognosis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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