Prognostic value of HPV DNA status in cervical cancer before treatment: a systematic review and meta-analysis

// Ping Li 1, 2, * , Yue Tan 1, 2, * , Li-Xia Zhu 3, * , Li-Na Zhou 1, 2 , Ping Zeng 2 , Qin Liu 3 , Min-Bin Chen 2 and Ye Tian 1 1 Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Institute of Radiotherapy and Oncology, Soochow University, Suzhou 215004, Jiangsu Province, China 2 Department of Radiotherapy and Oncology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Kunshan 215300, Jiangsu Province, China 3 Department of Gynecology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Kunshan 215300, Jiangsu Province, China * These authors contributed equally to this work and share co-first authors Correspondence to: Ye Tian, email: dryetian@126.com Keywords: HPV, cervical cancer, prognosis, overall survival, disease free survival Received: January 23, 2017      Accepted: May 19, 2017      Published: June 16, 2017 ABSTRACT Background: Human papillomavirus (HPV), has been recognized as an vital preliminary event in the oncogenesis of cervical cancer. But the prognostic value is not well defined, because of past studies showing conflicting results. So we conducted this meta-analysis to evaluate whether HPV DNA status was associated with prognosis in cervical cancer. Materials and Methods: A total of 17 previously published eligible studies including 2,838 cases were identified and included in this meta-analysis. Positive HPV DNA was associated with good prognosis in patients with cervical cancer (overall survival [OS]: pooled hazard ratio (HR) = 0.610, 95% confidence interval (CI) = 0.457−0.814, P = 0.001; disease free survival [DFS]: pooled HR = 0.362, 95% CI = 0.252−0.519, P < 0.001). Furthermore, in subgroup analysis, the results revealed that the association between HPV DNA positive cervical cancers and better OS (pooled HR = 0.534, 95 % CI = 0.355–0.804, P = 0.003) in Mongoloid patients. Similarly, it existed in good OS (pooled HR = 0.628, 95 % CI 0.429−0.922, P = 0.017) and DFS (pooled HR = 0.355, 95% CI = 0.226−0.559, P < 0.001) in Caucasian patients. Conclusions: HPV DNA status in cervical cancer may be a useful prognostic biomarker before carcinomas are treated. However, larger sample sizes and more comprehensive studies are required in the future studies to verify our findings.