title: Low initial human papillomavirus viral load may indicate worse prognosis in patients with cervical carcinoma treated with surgery.
abstract: OBJECTIVE
  To evaluate the prognostic implication of human papillomavirus (HPV) viral load in cervical cancer patients who underwent radical hysterectomy.
  
  
  METHODS
  We conducted a retrospective review of patients with stage IA2 through stage IIIA cervical carcinoma who underwent radical hysterectomy at Sun Yat-sen University Cancer Center between January 2005 and December 2009. Patients who had undergone preoperative hybrid capture 2 testing to detect HPV DNA were included. A total of 346 patients positive for HPV DNA were enrolled and stratified into two groups according to the median HPV viral load.
  
  
  RESULTS
  HPV viral load was significantly correlated with lymphovascular space invasion (p=0.026) and deep stromal invasion (p=0.024). However, other factors, such as age, stage, histologic grade, histologic type, lymph node metastasis, and tumor size, were not significantly associated with viral load. Low HPV viral load was correlated with poor disease-free survival in univariate analysis (p=0.037) and multivariate analysis (p=0.027). There was no significant difference in overall survival with regard to initial HPV viral load.
  
  
  CONCLUSIONS
  Low initial HPV viral load may be a poor prognostic factor for cervical cancer patients who have undergone radical hysterectomy.
authors: State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.; Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors: Ting
authors: T
authors: Deng
authors: State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.; Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors: Yanling
authors: Y
authors: Feng
authors: Department of Gynecology and Obstetrics, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Junsheng
authors: J
authors: Zheng
authors: State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.; Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors: Qidan
authors: Q
authors: Huang
authors: State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.; Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. liujh@mail.sysu.edu.cn.
authors: Jihong
authors: J
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000601:surgery / Q000821:virology; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000821:virology; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000821:virology; D019562:Viral Load; D055815:Young Adult
keywords: Disease-Free Survival; Human Papillomavirus DNA Tests; Hysterectomy; Uterine Cervical Neoplasms; Viral; Viral Load