Persistent human papillomavirus DNA is associated with local recurrence after radiotherapy of uterine cervical cancer

Yong Jung Song, Joo Young Kim, Su Kyoung Lee, Hyun Sun Lim, Myong Cheol Lim, Sang Soo Seo, Sokbom Kang, Dong Ock Lee, Sang Yoon Park

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Human papillomavirus (HPV) DNA is considered as a hallmark of cervical cancer. We investigated whether persistent HPV DNA at the cervix is associated with local recurrence after radiotherapy in patients with locally advanced cervical cancer. A total of 156 patients with HPV-positive cervical cancer (International Federation of Gynecology and Obstetrics stage IB-IVB) treated with radiotherapy between July 2003 and December 2006 were analyzed. HPV DNA was measured prior to radiotherapy and after completion of radiotherapy. The results of HPV DNA test at postradiotherapy 1, 3, 6 and 12 months were analyzed individually for association with local recurrence-free survival (LRFS). In addition, the result of any last follow-up HPV test within 24 months postradiotherapy was defined as the overall status of HPV at 24 months and was also analyzed for association with LRFS. HPV DNA was cleared in 127 patients (81.4%) and persistent in 29 patients (18.6%) by 24 months. In 18 patients with local recurrences, 14 patients (78%) showed positive HPV tests at 1-3 months. Among the various time points analyzed, a positive HPV test at 3 months was the most accurate predictor of local recurrence. Multivariate analysis indicated that overall status of HPV at 24 months, low HPV viral load and histologic grade as being significantly related to poor LRFS. In HPV-positive cervical carcinoma treated primarily with radiotherapy, persistent HPV DNA within 24 months after treatment indicates a high risk of local recurrence. Diagnostic accuracy of HPV test was highest at 3 months.

Original languageEnglish
Pages (from-to)896-902
Number of pages7
JournalInternational Journal of Cancer
Volume129
Issue number4
DOIs
StatePublished - 15 Aug 2011

Keywords

  • HPV
  • local recurrence
  • persistence
  • radiotherapy
  • uterine cervical cancer

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