title: Different outcome of invasive cervical cancer associated with high-risk versus intermediate-risk HPV genotype.
abstract: Human papillomavirus (HPV) DNA sequences are associated with the large majority of invasive cervical carcinoma but the role of specific genotype(s) in the outcome of the disease is still debated. To determine the viral epidemiology in the French population of patients and the prognostic value of HPV genotypes in cervical cancer, we performed a retrospective study in 515 patients treated in our Institution from 1985 to 2005. Ninety-six percent of the cases were found associated with HPV DNA whereas 4% remained HPV negative. High-risk HPV 16/18 genotypes were found in 70% of the cases. HPV 18 was more frequently associated with adenocarcinoma (40.6%) than HPV 16 (10.4%) and found in tumours developed in younger women (mean age, 45.8 years) than HPV 16 (48.3 years) or other HPV types (53.6 years). In multivariate analysis, node involvement (p < 0.0001), parametria invasion (p = 0.009), tumour size (p = 0.01) and HPV status (p = 0.02) were associated with disease-free survival (median follow-up 95 months). Disease outcome was better in tumours associated with intermediate risk HPV types (HPV 31, 33, 35, 39, 52, 53, 58, 59, 73) than in tumours with high oncogenic types (HPV 16, 18, 45) (p = 0.03). Node status and tumour size remained prognostic factor for overall survival. Our data show that HPV genotype is one of the biological factors associated with the outcome of cervical cancer. One third of invasive carcinoma were not associated with HPV 16/18, indicating that the screening for cervical neoplasia should be maintained after prophylactic vaccination against these HPV genotypes.
authors.affiliation: Department of Tumour Biology, Institut Curie, Paris, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: de Cremoux
authors.forename: Anne
authors.initials: A
authors.lastname: de la Rochefordière
authors.forename: Alexia
authors.initials: A
authors.lastname: Savignoni
authors.forename: Youlia
authors.initials: Y
authors.lastname: Kirova
authors.forename: Séverine
authors.initials: S
authors.lastname: Alran
authors.forename: Virginie
authors.initials: V
authors.lastname: Fourchotte
authors.forename: Corine
authors.initials: C
authors.lastname: Plancher
authors.forename: Martine
authors.initials: M
authors.lastname: Thioux
authors.forename: Rémy J
authors.initials: RJ
authors.lastname: Salmon
authors.forename: Paul
authors.initials: P
authors.lastname: Cottu
authors.forename: Laurent
authors.initials: L
authors.lastname: Mignot
authors.forename: Xavier
authors.initials: X
authors.lastname: Sastre-Garau
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications* / Q000235:genetics / Q000628:therapy; D011379:Prognosis; D012306:Risk; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000628:therapy* / Q000821:virology*
chemical_list: D004279:DNA, Viral