Persistence of human papillomavirus infection as a predictor for recurrence in carcinoma of the cervix after radiotherapy

Human papillomavirus infection and expression of ATPase family AAA domain containing 3A, a novel anti-autophagy factor, in uterine cervical cancer

“…Carcinogenicity of the high-risk HPV (hrHRV) is closely associated with E6 and E7 proteins, which can respectively inhibit activities of tumor suppressors, p53 and retinoblastoma protein (pRB), to interrupt cell growth regulation (10). Besides carcinogenesis, persistent HPV infection further correlates with tumor recurrence, cancer cell radiosensitivity and the resulting poor prognosis (11)(12)(13).…”

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

“…[9][10][11][12] In terms of radiotherapy outcome, several past studies showed that HPV persistence is associated with high rates of local recurrence and poor overall survival in patients with cervical cancer. 10,11 However, the status of HPV DNA was only examined at a single time point after radiotherapy in those studies, and hence, the pattern of HPV clearance after radiotherapy and the significance of positive HPV tests at individual time points was not subject to evaluation.In our study, HPV DNA was examined at multiple time points during the follow-up period after completion of radiotherapy. Absence or presence of HPV DNA at different time points was individually evaluated for association with local recurrence after radiotherapy.…”

“…Previous studies have examined the effectiveness of the HPV DNA test as a clinically useful marker for detecting residual disease or recurrence after conservative surgical procedures for cervical intraepithelial neoplasia [6][7][8] and also after radiotherapy. [9][10][11][12] In terms of radiotherapy outcome, several past studies showed that HPV persistence is associated with high rates of local recurrence and poor overall survival in patients with cervical cancer. 10,11 However, the status of HPV DNA was only examined at a single time point after radiotherapy in those studies, and hence, the pattern of HPV clearance after radiotherapy and the significance of positive HPV tests at individual time points was not subject to evaluation.…”

Follow-Up for Cervical Cancer: A Program in Evidence-Based Care Systematic Review and Clinical Practice Guideline Update

“…Both showed that, compared with Pap testing as reported in earlier studies, hpv dna testing had a much higher sensitivity for detection of recurrent cervical cancer after radiotherapy. The utility of such testing appears to be highest approximately 3 months after completion of treatment, because hpv dna persistence immediately after successful treatment could be a result of the presence of hpv dna or hpv dna sequence fragments (or both) in the degraded tumour cells or cell debris 18 . Although the results of these new studies are promising, the data are preliminary and require verification in higherquality studies with larger sample sizes.…”

“…The optimal follow-up interval still has not been conclusively determined, and a prospectively designed study to validate the effect of early detection on survival rates is needed 11 because the largest study to date has been a retrospective review 22 , and lead-time and length-time biases must be taken into consideration 20 . More specific topics in need of research include the time course of hpv dna clearance in invasive cervical carcinoma managed with radiation therapy 18 , trials of the tumour marker scc antigen during cervical cancer follow-up 11 , and prospective validation of pet-ct as a method of surveillance for asymptomatic women 20 . The idea of more-personalized follow-up programs, including routine biomarker testing during follow-up 11 or more frequent intervals for individuals at higher risk could allow for more individualized surveillance programs and could possibly improve the detection of asymptomatic recurrence early enough to allow for effective salvage or alternative treatment 18 .…”