Prevalence of human papillomavirus and its prognostic value in vulvar cancer: A systematic review and meta-analysis

Abstract

The purpose of this study was to estimate the prevalence of human papillomavirus (HPV) in vulvar cancer and determine whether positive HPV in vulvar cancer was associated with a better prognosis. Literature searches of Ovid EMBASE, PubMed, Web of Science and Cochrane Library were performed to identify related studies published from January 2000 to May 2017. A total of 33 studies including 7,721 subjects were selected in this meta-analysis. Overall, the HPV prevalence in vulvar cancer tissue was 34% (95% CI: 28%-39%) with 45% (95% CI: 28%-64%) in Asian populations and 34% (95% CI: 26%-42%) in Caucasian populations. The HPV-positive vulvar cancer was associated with better overall survival (hazard ratio = 0.64, 95% CI: 0.47–0.87; P = 0.004) and recurrence-free survival (hazard ratio = 0.66, 95% CI: 0.45–0.97; P = 0.03) compared with HPV-negative counterpart. HPV status may play an important role in predicting the prognosis of patients with vulvar cancer. The HPV-positive vulvar cancer women might relatively have a better survival than HPV-negative ones.

The impact of p16ink4a positivity in invasive vulvar cancer on disease-free and disease-specific survival, a retrospective study

“…Similar findings could be shown in a Scottish single-center study, where Wakeham et al reported a prognostic benefit on the clinical outcome of HPV-positive vulvar cancer [7]. In a meta-analysis including 7.721 patients, Zhang et al supported these results [8]. In a recently published Dutch study, Hinten et al described the combination of HPV and p16 ink4a positivity as a favorable prognostic factor in IVC [9].…”

Role of human papillomavirus infection in the etiology of vulvar cancer in Italian women

“…Mucosal HR-HPV types have been clearly associated with the development of a small subset of VSCC. However, the contribution of the viral infectious agents appears to vary in different geographical regions [15]. In particular, limited information is available for the contribution of HR-HPV to VSCC development in Italy.…”

“…Based on a pooled prevalence rate of HPV DNA, 34% of vulvar cancers have been reported to be attributable to HPV [15].…”

Predictive factors for lymph node metastases in vulvar cancer. An analysis of the AGO-CaRE-1 multicenter study

“…HPV-status, for example, might be an explanation for the increasing rate of LN metastasis with higher age. In older women HPVnegative tumors are more frequent and these are associated with shorter disease free survival [14]. Previous results are conflicting and based on small studies [11].…”