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Prognostic value of human papillomavirus in anal squamous cell carcinoma

  • Original Article
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Abstract

Purpose

Anal cancer is an uncommon malignancy, but its incidence is increasing worldwide. Chemoradiation is the standard primary treatment for patients with loco-regional limited disease. However, once patients develop metastatic spread, the prognosis is very poor. Human papillomavirus (HPV) is present in around 80 % of anal cancers, but its prognostic and/or predictive value is essentially unknown in this disease.

Methods

We retrospectively evaluated 50 patients with the diagnosis of anal squamous cell carcinoma treated at our institution with combined chemoradiotherapy for loco-regional limited disease. HPV status was evaluated from paraffin-embedded tumor tissues collected at the time of diagnosis by a polymerase chain reaction analysis.

Results

Among 50 patients, 42 (84 %) were HPV-positive. Thirty-two (64 %) patients were positive to genotype 16, two (4 %) to genotype 18, and three (6 %) to both 16 and 18. Lymph nodal involvement and clinical stage at diagnosis were more advanced for HPV-positive patients. After a median follow-up of 4 years (range 0.4–13.8), 46 (92 %) patients were alive. Overall, eight patients relapsed: One regional, one loco-regional, and six distant recurrences were observed. Four patients died of metastatic disease. Five-year disease-free survival (DFS) in HPV-positive and HPV-negative patients was 92.5 and 50.0 %, respectively (P < 0.01). In multivariate analysis, HPV-positivity was associated with a statistically significant better 5-year DFS (HR HPV+ vs HPV− 0.10; 95 % CI 0.02–0.50). Five-year overall survival in HPV-positive and HPV-negative patients was 93.3 and 66.7 %, respectively (P = 0.12).

Conclusions

In our study, HPV-positive anal cancers had a statistically significant improved DFS compared to HPV-negative group.

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Acknowledgments

The authors thank the patients for their inspiration of this original article. The authors indicate that no funding was received for this article.

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Unit of Gastrointestinal and Neuroendocrine Tumors, Division of Medical Oncology, European Institute of Oncology (IEO), Via Ripamonti 435, 20141, Milan, Italy

    Paola Simona Ravenda, Elena Magni, Nicola Fazio & Maria Giulia Zampino

  2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy

    Edoardo Botteri

  3. Division of Histopathology and Molecular Diagnostics, European Institute of Oncology, Milan, Italy

    Michela Manzotti, Massimo Barberis & Davide Vacirca

  4. Division of Endoscopy, European Institute of Oncology, Milan, Italy

    Cristina Maria Trovato

  5. Division of Radiotherapy, European Institute of Oncology, Milan, Italy

    Veronica Dell’Acqua & Maria Cristina Leonardi

  6. Division of Gynecology, European Institute of Oncology, Milan, Italy

    Mario Sideri

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  1. Paola Simona Ravenda
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  2. Elena Magni
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  3. Edoardo Botteri
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Correspondence to Paola Simona Ravenda.

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Ravenda, P.S., Magni, E., Botteri, E. et al. Prognostic value of human papillomavirus in anal squamous cell carcinoma. Cancer Chemother Pharmacol 74, 1033–1038 (2014). https://doi.org/10.1007/s00280-014-2582-x

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  • DOI: https://doi.org/10.1007/s00280-014-2582-x

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