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#Grand Rounds

Does HPV Impact Survival Following Treatment for Vulvar Cancer?

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BACKGROUND AND PURPOSE:

  • Incidence of vulvar cancer is increasing in younger women
  • There is evidence that high-risk (HPV) infection is a predictive marker for survival in other malignancies such as oropharyngeal cancer
  • Data on the relationship between HPV and vulvar cancer survival is limited
  • Rasmussen et al. (Int J Cancer, 2017) examined whether HPV status influences survival after vulvar cancer

METHODS:

  • Systematic review and meta-analysis
  • 18 studies were deemed acceptable for inclusion into this study
  • Studies were included if survival outcomes after histologically verified vulvar cancers in relation to HPV were analyzed
  • Different disease survival parameters were assessed
    • Overall survival (OS)
    • Disease free survival (DFS)
    • Disease specific survival (DSS)
    • Progression free survival (PFS)

RESULTS:

  • Data from 1,638 women were included
    • 541 were HPV positive and 1097 were HPV negative
  • Women with vulvar cancer had better survival if HPV positive
    • Pooled hazard ratio (HR) of 0.61 (95%CI, 0.48–0.77; p<0.001) and 0.75 (95%CI, 0.57–1.00; p=0.049) for 5-year OS and DFS, respectively
  • Results for DSS and PFS were not significant but suggest a more favorable outcome for women who are HPV positive

CONCLUSION:

  • This study represents the first meta-analysis on this topic
  • Women with HPV positive vulvar cancers have a greater chance of survival compared to women with HPV negative
  • HPV negative tumors may require more intensive follow up for recurrence
  • Further studies to guide optimal management are warranted

Learn More – Primary Sources:

Does HPV status influence survival after vulvar cancer?

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Related ObG Topics:

Does HPV Testing in the Setting of ASC-US Impact Long Term Outcomes?
What to Do with a Normal Pap but Positive HPV, ASC-US, LSIL and ASC-H
HPV Vaccine Recommendations Including Guidance for Ages 27 to 45

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