title: HPV-18 is a poor prognostic factor, unlike the HPV viral load, in patients with stage IB-IIA cervical cancer undergoing radical hysterectomy.
abstract: OBJECTIVE
  This study was conducted to determine the prognostic significance of the human papillomavirus (HPV) genotype using the HPV DNA chip (HDC) test and the HPV viral load by the hybrid capture II assay (HC2) in FIGO stage IB-IIA cervical cancer undergoing radical hysterectomy.
  
  
  METHODS
  Between January 2001 and December 2005, 204 consecutive patients who underwent radical hysterectomy with pelvic lymphadenectomy for International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer were retrospectively reviewed. The Cox proportional hazard models adjusted for covariates were used for analyses and a receiver operating characteristic (ROC) curve was used to determine the HPV viral load in predicting disease progression.
  
  
  RESULTS
  Of the 204 cases, the HDC was positive in 195 (95.6%) and the HC2 was positive in 192 (94.1%). The 5-year progression-free survival (PFS) was 78.4%. On multivariate analysis, HPV-18 positivity was an independent prognostic factor predictive for disease progression. The risk of recurrence was higher for HPV-18 positivity (hazard ratio=2.664; 95% confidence interval [CI], 1.437-4.938; P=0.003). The 5-year PFS rate for patients who were HPV-18-negative was 83.8%, which was higher than the 5-year PFS for patients who were HPV-18-positive (54.1%; P<0.001). The area under the ROC curve for the HPV viral load was 0.550 (P=0.314; 95% CI, 0.455-0.644).
  
  
  CONCLUSIONS
  The HPV-18 genotype is a reliable prognostic factor of early-stage cervical cancer; however, the HPV viral load may not be helpful in predicting disease prognosis.
authors.affiliation: Department of Obstetrics and Gynecology, Chonnam National University Medical School, 8 Hakdong, Dong-gu, Gwangju, Republic of Korea
authors.forename: Woo Dae
authors.initials: WD
authors.lastname: Kang
authors.forename: Cheol Hong
authors.initials: CH
authors.lastname: Kim
authors.forename: Moon Kyoung
authors.initials: MK
authors.lastname: Cho
authors.forename: Jong Woon
authors.initials: JW
authors.lastname: Kim
authors.forename: Hye Yon
authors.initials: HY
authors.lastname: Cho
authors.forename: Yoon Ha
authors.initials: YH
authors.lastname: Kim
authors.forename: Ho Sun
authors.initials: HS
authors.lastname: Choi
authors.forename: Seok Mo
authors.initials: SM
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D005838:Genotype; D052161:Human papillomavirus 18 / Q000235:genetics / Q000502:physiology*; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D020411:Oligonucleotide Array Sequence Analysis; D030361:Papillomavirus Infections / Q000473:pathology / Q000821:virology*; D012372:ROC Curve; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D019562:Viral Load
chemical_list: D004279:DNA, Viral