Role of human papillomavirus genotype in prognosis of early-stage cervical cancer undergoing primary surgery

Chyong Huey Lai, Chee Jen Chang, Huei Jean Huang, Swei Hsueh, Angel Chao, Jung Erh Yang, Cheng Tao Lin, Shang Lang Huang, Ji Hong Hong, Hung Hsueh Chou, Tzu I. Wu, Kuan Gen Huang, Chun Chieh Wang, Ting Chang Chang

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Purpose: Our aim was to evaluate the prognostic significance of human papillomavirus (HPV) genotype in early-stage cervical carcinoma primarily treated with surgery in a large tertiary referral medical center. Patients and Methods: Consecutive patients who underwent primary surgery for invasive cervical carcinoma of International Federation of Gynecology and Obstetrics (FIGO) stage I to IIA between 1993 and 2000 were retrospectively reviewed. Polymerase chain reaction (PCR) using a general primer set followed by reverse-blot detection of 38 types of HPV DNA in a single reaction was performed for genotyping. E6 type-specific PCR was performed to validate multiple types. Results: A total of 1,067 eligible patients were analyzed. HPV DNA sequences were detected in 95.1% of the specimens, among which 9.6% contained multiple types. HPV 16 was detected in 63.8% of the samples, and HPV 18 was detected in 16.5% of the samples. The median follow-up time of surviving patients was 77 months. By multivariate analysis, FIGO stage, lymph node metastasis, depth of cervical stromal invasion, grade of differentiation, and HPV 18 positivity were significantly related to cancer relapse. FIGO stage II, deep stromal invasion, parametrial extension, HPV 18 positivity, and age older than 45 years were significant predictors for death. Using the seven selected variables from either recurrence-free or overall survival analysis, death-predicting (P <.0001) and relapse-predicting (P <.0001) models classifying three risk groups (low, intermediate, and high risk) were constructed and endorsed by internal validation. Conclusion: The independent prognostic value of HPV genotype is confirmed in this study. The prognostic models could be useful in counseling patients and stratifying patients in future clinical trials.

Original languageEnglish
Pages (from-to)3628-3634
Number of pages7
JournalJournal of Clinical Oncology
Volume25
Issue number24
DOIs
Publication statusPublished - Aug 20 2007
Externally publishedYes

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Uterine Cervical Neoplasms
Genotype
Human papillomavirus 18
Gynecology
Obstetrics
Recurrence
Carcinoma
Polymerase Chain Reaction
Human papillomavirus 16
Survival Analysis
Tertiary Care Centers
Counseling
Multivariate Analysis
Lymph Nodes
Clinical Trials
Neoplasm Metastasis
DNA
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Lai, C. H., Chang, C. J., Huang, H. J., Hsueh, S., Chao, A., Yang, J. E., ... Chang, T. C. (2007). Role of human papillomavirus genotype in prognosis of early-stage cervical cancer undergoing primary surgery. Journal of Clinical Oncology, 25(24), 3628-3634. https://doi.org/10.1200/JCO.2007.11.2995

Role of human papillomavirus genotype in prognosis of early-stage cervical cancer undergoing primary surgery. / Lai, Chyong Huey; Chang, Chee Jen; Huang, Huei Jean; Hsueh, Swei; Chao, Angel; Yang, Jung Erh; Lin, Cheng Tao; Huang, Shang Lang; Hong, Ji Hong; Chou, Hung Hsueh; Wu, Tzu I.; Huang, Kuan Gen; Wang, Chun Chieh; Chang, Ting Chang.

In: Journal of Clinical Oncology, Vol. 25, No. 24, 20.08.2007, p. 3628-3634.

Research output: Contribution to journalArticle

Lai, CH, Chang, CJ, Huang, HJ, Hsueh, S, Chao, A, Yang, JE, Lin, CT, Huang, SL, Hong, JH, Chou, HH, Wu, TI, Huang, KG, Wang, CC & Chang, TC 2007, 'Role of human papillomavirus genotype in prognosis of early-stage cervical cancer undergoing primary surgery', Journal of Clinical Oncology, vol. 25, no. 24, pp. 3628-3634. https://doi.org/10.1200/JCO.2007.11.2995
Lai, Chyong Huey ; Chang, Chee Jen ; Huang, Huei Jean ; Hsueh, Swei ; Chao, Angel ; Yang, Jung Erh ; Lin, Cheng Tao ; Huang, Shang Lang ; Hong, Ji Hong ; Chou, Hung Hsueh ; Wu, Tzu I. ; Huang, Kuan Gen ; Wang, Chun Chieh ; Chang, Ting Chang. / Role of human papillomavirus genotype in prognosis of early-stage cervical cancer undergoing primary surgery. In: Journal of Clinical Oncology. 2007 ; Vol. 25, No. 24. pp. 3628-3634.
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abstract = "Purpose: Our aim was to evaluate the prognostic significance of human papillomavirus (HPV) genotype in early-stage cervical carcinoma primarily treated with surgery in a large tertiary referral medical center. Patients and Methods: Consecutive patients who underwent primary surgery for invasive cervical carcinoma of International Federation of Gynecology and Obstetrics (FIGO) stage I to IIA between 1993 and 2000 were retrospectively reviewed. Polymerase chain reaction (PCR) using a general primer set followed by reverse-blot detection of 38 types of HPV DNA in a single reaction was performed for genotyping. E6 type-specific PCR was performed to validate multiple types. Results: A total of 1,067 eligible patients were analyzed. HPV DNA sequences were detected in 95.1{\%} of the specimens, among which 9.6{\%} contained multiple types. HPV 16 was detected in 63.8{\%} of the samples, and HPV 18 was detected in 16.5{\%} of the samples. The median follow-up time of surviving patients was 77 months. By multivariate analysis, FIGO stage, lymph node metastasis, depth of cervical stromal invasion, grade of differentiation, and HPV 18 positivity were significantly related to cancer relapse. FIGO stage II, deep stromal invasion, parametrial extension, HPV 18 positivity, and age older than 45 years were significant predictors for death. Using the seven selected variables from either recurrence-free or overall survival analysis, death-predicting (P <.0001) and relapse-predicting (P <.0001) models classifying three risk groups (low, intermediate, and high risk) were constructed and endorsed by internal validation. Conclusion: The independent prognostic value of HPV genotype is confirmed in this study. The prognostic models could be useful in counseling patients and stratifying patients in future clinical trials.",
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AU - Chao, Angel

AU - Yang, Jung Erh

AU - Lin, Cheng Tao

AU - Huang, Shang Lang

AU - Hong, Ji Hong

AU - Chou, Hung Hsueh

AU - Wu, Tzu I.

AU - Huang, Kuan Gen

AU - Wang, Chun Chieh

AU - Chang, Ting Chang

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N2 - Purpose: Our aim was to evaluate the prognostic significance of human papillomavirus (HPV) genotype in early-stage cervical carcinoma primarily treated with surgery in a large tertiary referral medical center. Patients and Methods: Consecutive patients who underwent primary surgery for invasive cervical carcinoma of International Federation of Gynecology and Obstetrics (FIGO) stage I to IIA between 1993 and 2000 were retrospectively reviewed. Polymerase chain reaction (PCR) using a general primer set followed by reverse-blot detection of 38 types of HPV DNA in a single reaction was performed for genotyping. E6 type-specific PCR was performed to validate multiple types. Results: A total of 1,067 eligible patients were analyzed. HPV DNA sequences were detected in 95.1% of the specimens, among which 9.6% contained multiple types. HPV 16 was detected in 63.8% of the samples, and HPV 18 was detected in 16.5% of the samples. The median follow-up time of surviving patients was 77 months. By multivariate analysis, FIGO stage, lymph node metastasis, depth of cervical stromal invasion, grade of differentiation, and HPV 18 positivity were significantly related to cancer relapse. FIGO stage II, deep stromal invasion, parametrial extension, HPV 18 positivity, and age older than 45 years were significant predictors for death. Using the seven selected variables from either recurrence-free or overall survival analysis, death-predicting (P <.0001) and relapse-predicting (P <.0001) models classifying three risk groups (low, intermediate, and high risk) were constructed and endorsed by internal validation. Conclusion: The independent prognostic value of HPV genotype is confirmed in this study. The prognostic models could be useful in counseling patients and stratifying patients in future clinical trials.

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