title: Human papillomavirus 18 as a poor prognostic factor in stage I-IIA cervical cancer following primary surgical treatment.
abstract: OBJECTIVE
  This study evaluates the effect of the specific human papillomavirus (HPV) genotype as a prognostic factor in stage I-IIA cervical cancer patients following primary surgical treatment.
  
  
  METHODS
  The medical records of 116 cervical cancer patients treated with primary surgical treatment were reviewed. The HPV genotypes were categorized into following groups: negative and unclassified, HPV 16, HPV 18, and other high risk (HPV 31, 33, 35, 45, 51, 52, 56, and 58).
  
  
  RESULTS
  Among the HPV genotypes, HPV 16 predominated (40.52%), followed by intermediate risk and unclassified (25%), HPV 18, 45, and 56 (17.24%) and negative (17.24%). In univariate analysis, HPV genotypes (P=0.03), parametrial spread (P=0.02), depth of invasion (DOI) (P<0.01) and lymph-vascular space invasion (P=0.02) were significantly associated with progression free survival (PFS). In multivariate analysis, HPV 18 (hazard ratio [HR], 5.2; 95% confidence interval [CI], 1.29 to 20.90; P=0.02) and ≥one half of DOI (HR, 5.4; 95% CI, 1.08 to 27.31; P=0.04) were significantly associated with PFS. HPV genotypes are not significantly associated with overall survival.
  
  
  CONCLUSIONS
  HPV 18 was a poor prognostic factor for the PFS in stage I-IIA cervical cancer patients following primary surgical treatment. Careful long-term observation and regular exams are recommended for cervical cancer patients with HPV 18 compared to those with other HPV genotypes.
authors.affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sun-Hye
authors.initials: SH
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Su-Kyoung
authors.initials: SK
authors.lastname: Kong
authors.affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: So-Yi
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Chan-Yong
authors.initials: CY
authors.lastname: Park
keywords: Genotype; Human papillomavirus; Prognosis; Uterine cervical neoplasms