title: The prognostic role of human papillomavirus in patients with vaginal cancer.
abstract: OBJECTIVE
  The objective of the study was to evaluate the association between human papillomavirus (HPV) infection and clinical-pathological parameters in primary squamous cell carcinoma of the vagina and assess the value of HPV infection as a prognostic parameter.
  
  
  METHODS
  In our retrospective study, we identified 37 consecutive patients with primary invasive squamous cell carcinoma of the vagina; 35 patients were eligible for further investigations. Human papillomavirus detection was assessed by in situ hybridization assays from paraffin-embedded tissue blocks. Human papillomavirus detection was correlated with clinical-pathological parameters by χ² and Fisher exact tests. Univariate log-rank tests and multivariate Cox regression models were used to evaluate the association between HPV infection and patient survival.
  
  
  RESULTS
  Human papillomavirus DNA was detected in 18 (51.4%) of 35 cases. Human papillomavirus status did no influence clinical-pathological parameters, such as clinical stage (P=0.9), grade (P=0.9), and tumor size (P=0.18). Prognosis did not significantly differ between HPV-positive and HPV-negative tumors in the entire cohort; however, patients with unfavorable tumor stage (International Federation of Gynecology and Obstetrics stage≥III) and HPV positivity had improved disease-free (P=0.004) and overall survival (P=0.023).
  
  
  CONCLUSIONS
  Human papillomavirus infection was frequently detected in squamous cell carcinoma of the vagina, and its presence may serve as a prognostic indicator in advanced stages.
authors.affiliation: Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria. dr.andreas.brunner@utanet.at
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Brunner
authors.forename: Christoph
authors.initials: C
authors.lastname: Grimm
authors.forename: Stephan
authors.initials: S
authors.lastname: Polterauer
authors.forename: Lukas
authors.initials: L
authors.lastname: Hefler
authors.forename: Josefine
authors.initials: J
authors.lastname: Stani
authors.forename: Georg
authors.initials: G
authors.lastname: Heinze
authors.forename: Reinhard
authors.initials: R
authors.lastname: Horvat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000502:physiology*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D017403:In Situ Hybridization; D008875:Middle Aged; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000821:virology*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000821:virology*