Prognostic importance of human papillomavirus (HPV) and p16 positivity in squamous cell carcinoma of the vulva treated with radiotherapy

Lee, Larissa J.; Howitt, Brooke E.; Catalano, Paul J.; Tanaka, C.; Murphy, Raymond L. H.; Cimbak, Nicole; DeMaria, Rebecca; Bu, Paula; Crum, Christopher P.; Horowitz, Neil S.; Matulonis, Ursula A.; Viswanathan, Akila N.

doi:10.1016/j.ygyno.2016.05.019

Cited by 100 publications

(85 citation statements)

References 37 publications

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“…A strength of this study is the rigorous analysis of HPV status of patients’ tumours, established by sequential analysis of histomorphology, p16 IHC and direct HPV testing . Our results are consistent with previous studies on SCC in the vulva, including recent reports by Hay (92 patients) and Lee (57 patients). Another recent study by Dong (97 patients) showed a significant association between p16 expression and survival, but the association was not independent of patient age on multivariable analysis as in our study.…”

Section: Discussionsupporting

confidence: 89%

“…A possible reason for the better prognosis of HPV‐associated VSCC may be their relative radiosensitivity, as suggested for SCCs at other anatomical sites, or they may have a better outcome independent of treatment method, as in HNSCC . Indeed, a recent study by Lee and colleagues indicates that patients with p16‐positive, HPV‐associated vulvar cancers have decreased recurrence and improved survival after radiation therapy . Multiple biological explanations have been put forth to explain the improved radiation response of HPV‐positive oropharyngeal SCC, including decreased DNA repair, rapid resolution of hypoxia, differential activation of signal transduction pathways and enhanced immune response .…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to head and neck squamous cell carcinoma (HNSCC), where HPV‐associated tumours clearly have a significantly better prognosis, in particular for oropharyngeal cancers, the prognostic significance of HPV in VSCC is not established firmly. Some studies of VSCC have shown that HPV‐associated tumours have a better prognosis, whereas others have not . The treatment of VSCC has evolved over the past two decades, away from radical en‐bloc dissections and full groin lymphadenectomies towards localized radical vulvectomy with separate incisions for groin and vulva, and sentinel lymph node biopsy .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Human papillomavirus (HPV)‐independent vulvar squamous cell carcinoma has a worse prognosis than HPV‐associated disease: a retrospective cohort study

et al. 2017

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Human papillomavirus (HPV)‐independent vulvar squamous cell carcinoma has a worse prognosis than HPV‐associated disease: a retrospective cohort study

et al. 2017

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“…[24,25]. However, some studies have shown that HPV indicates a less aggressive tumour form with less potential of recurrence [26,27]. Other studies on HPV and recurrence risk also have contrary results [28,29,30].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Age on the Prognosis of Vulvar Cancer

Hami

Lampe²,

Mallmann

et al. 2018

Oncol Res Treat

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Introduction: Younger women are particularly affected by the increase in the incidence of vulvar cancer. The purpose of this study was to investigate how clinical characteristics differ depending on the patient´s age and what role the age of initial diagnosis plays in the prognosis. Patients andMethods: Included patients were divided into groups aged below or above 50 years. The disease-free survival (DFS) was calculated and a multivariate discriminant analysis was conducted. Results: Of the 300 patients, 79 were ≤50 years and 221 were >50 years. The median age was 64 years (19-96 years). There were no differences between the groups regarding lymph node (LN) status and distant metastasis, but T1 tumours were more frequent in patients ≤50 years (77% vs. 62%, p = 0.02). The DFS only differed between the groups when there were no LN metastases. The nodal status was the predominant prognostic factor for the DFS regardless of age. In node-free patients, the 5-year DFS was 49% for the ≤50 years group and 89% for the >50 years group (p = 0.008), whereas there was no difference if a LN was involved. Conclusion: In node-free patients, the risk for recurrence is lower for patients older than 50 years.

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“…With the recognition of the prognostic significance of HPV status in patients with invasive VSCC, the question arises of whether this information can be used to guide treatment and improve patient outcomes. A number of studies have suggested that HPV‐associated VSCC is more radiosensitive than HPV‐independent VSCC . This is a particularly plausible hypothesis, given that the same differential sensitivity to radiation has been shown for head and neck squamous cell carcinomas .…”

Section: Impact Of Hpv Status On Treatmentmentioning

confidence: 94%

Vulval squamous cell carcinoma and its precursors

2019

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Vulval squamous cell carcinoma (VSCC) can arise through two distinct pathways [human papillomavirus (HPV)‐associated and HPV‐independent], and these VSCC variants are recognised as different disease entities on the basis of different aetiologies, morphological features, molecular events during oncogenesis, precursor lesions, prognosis, and response to treatment. The precursor of HPV‐associated VSCC, variously referred to as high‐grade squamous intraepithelial lesion (HSIL) [vulvar intraepithelial neoplasia (VIN) 2/3] or usual‐type VIN, is morphologically identical to the more common HSIL (cervical intraepithelial neoplasia 2/3) of the cervix. The precursor lesions of HPV‐independent VSCC include differentiated VIN, differentiated exophytic vulvar intraepithelial lesion, and vulvar acanthosis with altered differentiation; these have been under‐recognised by pathologists in the past, leading to delays in treatment. This review will discuss the recent advances in diagnostic surgical pathology of VSCC and its precursors, and how these diagnoses can impact on patient management.

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Prognostic importance of human papillomavirus (HPV) and p16 positivity in squamous cell carcinoma of the vulva treated with radiotherapy

Cited by 100 publications

References 37 publications

Human papillomavirus (HPV)‐independent vulvar squamous cell carcinoma has a worse prognosis than HPV‐associated disease: a retrospective cohort study

Human papillomavirus (HPV)‐independent vulvar squamous cell carcinoma has a worse prognosis than HPV‐associated disease: a retrospective cohort study

The Impact of Age on the Prognosis of Vulvar Cancer

Vulval squamous cell carcinoma and its precursors

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