TY - JOUR
T1 - Peritoneal HPV-DNA test in cervical cancer (PIONEER study)
T2 - A proof of concept
AU - Bizzarri, Nicolò
AU - Pedone Anchora, Luigi
AU - Cattani, Paola
AU - De Vincenzo, Rosa
AU - Marchetti, Simona
AU - Conte, Carmine
AU - Chiantera, Vito
AU - Gallotta, Valerio
AU - Gueli Alletti, Salvatore
AU - Vizzielli, Giuseppe
AU - Costantini, Barbara
AU - Fagotti, Anna
AU - Fanfani, Francesco
AU - Scambia, Giovanni
AU - Ferrandina, Gabriella
N1 - Funding Information:
The authors thank the surgical team and the scrub nurses at Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Publisher Copyright:
© 2020 Union for International Cancer Control
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - The aim of this study was to investigate the prevalence of peritoneal human papillomavirus (HPV) infection in different clinical cervical cancer (CC) settings, and its association with potential clinical and/or histological factors. This is a single-center, prospective, observational study. Consecutive patients with newly diagnosed or recurrent/persistent CC, between March 2019 and April 2020, were included. A group of patients undergoing surgery for benign gynecological conditions was included as control group. All patients underwent HPV-DNA test in the cervix and in the peritoneal cavity simultaneously at time of surgery. Two-hundred seventy-two patients had cervical and peritoneal HPV test analyzed. Cervical and peritoneal HPV positivity (PHP) was found in 235 (88.0%) and 78 (28.7%) patients, respectively; the prevalence of PHP was 17.7% in early stage, 28.8% in locally advanced cervical cancer (LACC) and 46.6% in the metastatic/persistent/recurrent setting (P =.001). No control patient was found to have peritoneal HPV infection. Higher frequency of PHP was documented in patients with larger tumor size (P =.003), presence of cervical HPV 16/18 genotypes (P <.001), higher number of cervical high-risk (HR)-HPV per patient (P =.018) and peritoneal carcinomatosis (P <.001). Multivariate analysis demonstrated that lack of preoperative cervical conization in early stages (P =.030), while higher International Federation of Gynecology and Obstetrics (FIGO) stage (P =.021) and presence of cervical HPV 16/18 (P =.001) in LACC, was associated with PHP. This is a proof-of-concept study. A number of potential clinical implications, including prognosis, could be obtained by further studies.
AB - The aim of this study was to investigate the prevalence of peritoneal human papillomavirus (HPV) infection in different clinical cervical cancer (CC) settings, and its association with potential clinical and/or histological factors. This is a single-center, prospective, observational study. Consecutive patients with newly diagnosed or recurrent/persistent CC, between March 2019 and April 2020, were included. A group of patients undergoing surgery for benign gynecological conditions was included as control group. All patients underwent HPV-DNA test in the cervix and in the peritoneal cavity simultaneously at time of surgery. Two-hundred seventy-two patients had cervical and peritoneal HPV test analyzed. Cervical and peritoneal HPV positivity (PHP) was found in 235 (88.0%) and 78 (28.7%) patients, respectively; the prevalence of PHP was 17.7% in early stage, 28.8% in locally advanced cervical cancer (LACC) and 46.6% in the metastatic/persistent/recurrent setting (P =.001). No control patient was found to have peritoneal HPV infection. Higher frequency of PHP was documented in patients with larger tumor size (P =.003), presence of cervical HPV 16/18 genotypes (P <.001), higher number of cervical high-risk (HR)-HPV per patient (P =.018) and peritoneal carcinomatosis (P <.001). Multivariate analysis demonstrated that lack of preoperative cervical conization in early stages (P =.030), while higher International Federation of Gynecology and Obstetrics (FIGO) stage (P =.021) and presence of cervical HPV 16/18 (P =.001) in LACC, was associated with PHP. This is a proof-of-concept study. A number of potential clinical implications, including prognosis, could be obtained by further studies.
KW - cervical cancer
KW - genotypes
KW - HPV
KW - infection
KW - peritoneum
KW - prognostic factors
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U2 - 10.1002/ijc.33380
DO - 10.1002/ijc.33380
M3 - Article
C2 - 33152105
AN - SCOPUS:85096709890
VL - 148
SP - 1197
EP - 1207
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
IS - 5
ER -