Low initial human papilloma viral load implicates worse prognosis in patients with uterine cervical cancer treated with radiotherapy

Joo Young Kim, Sohee Park, Byung Ho Nam, Ju Won Roh, Chae Hyeong Lee, Yoon Hee Kim, Hye Jin Shin, Su Kyoung Lee, Sun Young Kong, Moon-Woo Seong, Tae Jin Han, Me Yeon Lee, Kwan Ho Cho, Sang Yoon Park

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate whether human papillomavirus (HPV) viral load measured in cervical smear and HPV type 18 are associated with radiotherapy outcomes in uterine cervical cancer. Patients and Methods: HPV DNA was semiquantitatively measured in the cervical smears of 169 radiotherapy patients. HPV viral load was classified as low or high according to median HPV DNA titer and examined for its prognostic value. The multivariable Cox proportional hazards model was used to adjust for covariates. A relapse-predicting model was constructed to classify three risk groups for diseasefree survival (DFS), which were used for internal validation. Results: Patients with lower HPV viral load showed worse DFS in univariate analysis. HPV type 18, younger patient age, stage group, nodal status, histologic grade, and histologic type were other prognostic factors for poor DFS. Among these factors, all except stage group were associated with HPV viral load. Multivariate analysis showed the strong influence of HPV viral load for poor DFS. The prognostic model developed using our outcome data performed well in predicting the risk of relapse. Conclusion: Our data suggest that HPV viral load is a strong independent prognostic factor for DFS. HPV type 18 showed a significant relationship with poor radiotherapy outcome in univariate analysis, but not in multivariate analysis.

Original languageEnglish
Pages (from-to)5088-5093
Number of pages6
JournalJournal of Clinical Oncology
Volume27
Issue number30
DOIs
StatePublished - 20 Oct 2009

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Papilloma
Viral Load
Uterine Cervical Neoplasms
Radiotherapy
Human papillomavirus 18
Survival
Vaginal Smears
Multivariate Analysis
Recurrence
DNA
Proportional Hazards Models
Age Groups

Cite this

Kim, Joo Young ; Park, Sohee ; Nam, Byung Ho ; Roh, Ju Won ; Lee, Chae Hyeong ; Kim, Yoon Hee ; Shin, Hye Jin ; Lee, Su Kyoung ; Kong, Sun Young ; Seong, Moon-Woo ; Han, Tae Jin ; Lee, Me Yeon ; Cho, Kwan Ho ; Park, Sang Yoon. / Low initial human papilloma viral load implicates worse prognosis in patients with uterine cervical cancer treated with radiotherapy. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 30. pp. 5088-5093.
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title = "Low initial human papilloma viral load implicates worse prognosis in patients with uterine cervical cancer treated with radiotherapy",
abstract = "Purpose: To evaluate whether human papillomavirus (HPV) viral load measured in cervical smear and HPV type 18 are associated with radiotherapy outcomes in uterine cervical cancer. Patients and Methods: HPV DNA was semiquantitatively measured in the cervical smears of 169 radiotherapy patients. HPV viral load was classified as low or high according to median HPV DNA titer and examined for its prognostic value. The multivariable Cox proportional hazards model was used to adjust for covariates. A relapse-predicting model was constructed to classify three risk groups for diseasefree survival (DFS), which were used for internal validation. Results: Patients with lower HPV viral load showed worse DFS in univariate analysis. HPV type 18, younger patient age, stage group, nodal status, histologic grade, and histologic type were other prognostic factors for poor DFS. Among these factors, all except stage group were associated with HPV viral load. Multivariate analysis showed the strong influence of HPV viral load for poor DFS. The prognostic model developed using our outcome data performed well in predicting the risk of relapse. Conclusion: Our data suggest that HPV viral load is a strong independent prognostic factor for DFS. HPV type 18 showed a significant relationship with poor radiotherapy outcome in univariate analysis, but not in multivariate analysis.",
author = "Kim, {Joo Young} and Sohee Park and Nam, {Byung Ho} and Roh, {Ju Won} and Lee, {Chae Hyeong} and Kim, {Yoon Hee} and Shin, {Hye Jin} and Lee, {Su Kyoung} and Kong, {Sun Young} and Moon-Woo Seong and Han, {Tae Jin} and Lee, {Me Yeon} and Cho, {Kwan Ho} and Park, {Sang Yoon}",
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Kim, JY, Park, S, Nam, BH, Roh, JW, Lee, CH, Kim, YH, Shin, HJ, Lee, SK, Kong, SY, Seong, M-W, Han, TJ, Lee, MY, Cho, KH & Park, SY 2009, 'Low initial human papilloma viral load implicates worse prognosis in patients with uterine cervical cancer treated with radiotherapy', Journal of Clinical Oncology, vol. 27, no. 30, pp. 5088-5093. https://doi.org/10.1200/JCO.2009.22.4659

Low initial human papilloma viral load implicates worse prognosis in patients with uterine cervical cancer treated with radiotherapy. / Kim, Joo Young; Park, Sohee; Nam, Byung Ho; Roh, Ju Won; Lee, Chae Hyeong; Kim, Yoon Hee; Shin, Hye Jin; Lee, Su Kyoung; Kong, Sun Young; Seong, Moon-Woo; Han, Tae Jin; Lee, Me Yeon; Cho, Kwan Ho; Park, Sang Yoon.

In: Journal of Clinical Oncology, Vol. 27, No. 30, 20.10.2009, p. 5088-5093.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Low initial human papilloma viral load implicates worse prognosis in patients with uterine cervical cancer treated with radiotherapy

AU - Kim, Joo Young

AU - Park, Sohee

AU - Nam, Byung Ho

AU - Roh, Ju Won

AU - Lee, Chae Hyeong

AU - Kim, Yoon Hee

AU - Shin, Hye Jin

AU - Lee, Su Kyoung

AU - Kong, Sun Young

AU - Seong, Moon-Woo

AU - Han, Tae Jin

AU - Lee, Me Yeon

AU - Cho, Kwan Ho

AU - Park, Sang Yoon

PY - 2009/10/20

Y1 - 2009/10/20

N2 - Purpose: To evaluate whether human papillomavirus (HPV) viral load measured in cervical smear and HPV type 18 are associated with radiotherapy outcomes in uterine cervical cancer. Patients and Methods: HPV DNA was semiquantitatively measured in the cervical smears of 169 radiotherapy patients. HPV viral load was classified as low or high according to median HPV DNA titer and examined for its prognostic value. The multivariable Cox proportional hazards model was used to adjust for covariates. A relapse-predicting model was constructed to classify three risk groups for diseasefree survival (DFS), which were used for internal validation. Results: Patients with lower HPV viral load showed worse DFS in univariate analysis. HPV type 18, younger patient age, stage group, nodal status, histologic grade, and histologic type were other prognostic factors for poor DFS. Among these factors, all except stage group were associated with HPV viral load. Multivariate analysis showed the strong influence of HPV viral load for poor DFS. The prognostic model developed using our outcome data performed well in predicting the risk of relapse. Conclusion: Our data suggest that HPV viral load is a strong independent prognostic factor for DFS. HPV type 18 showed a significant relationship with poor radiotherapy outcome in univariate analysis, but not in multivariate analysis.

AB - Purpose: To evaluate whether human papillomavirus (HPV) viral load measured in cervical smear and HPV type 18 are associated with radiotherapy outcomes in uterine cervical cancer. Patients and Methods: HPV DNA was semiquantitatively measured in the cervical smears of 169 radiotherapy patients. HPV viral load was classified as low or high according to median HPV DNA titer and examined for its prognostic value. The multivariable Cox proportional hazards model was used to adjust for covariates. A relapse-predicting model was constructed to classify three risk groups for diseasefree survival (DFS), which were used for internal validation. Results: Patients with lower HPV viral load showed worse DFS in univariate analysis. HPV type 18, younger patient age, stage group, nodal status, histologic grade, and histologic type were other prognostic factors for poor DFS. Among these factors, all except stage group were associated with HPV viral load. Multivariate analysis showed the strong influence of HPV viral load for poor DFS. The prognostic model developed using our outcome data performed well in predicting the risk of relapse. Conclusion: Our data suggest that HPV viral load is a strong independent prognostic factor for DFS. HPV type 18 showed a significant relationship with poor radiotherapy outcome in univariate analysis, but not in multivariate analysis.

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DO - 10.1200/JCO.2009.22.4659

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SP - 5088

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JO - Journal of Clinical Oncology

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SN - 0732-183X

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