The aim of this study was to investigate the prevalence of peritoneal Human Papillomavirus (HPV) infection in different clinical cervical cancer (CC) settings, and its association with potential clinical and/or histological factors. This is a single-center, prospective, observational study. Consecutive patients with newly diagnosed or recurrent/persistent CC, between 03/2019 and 04/2020, were included. A group of patients undergoing surgery for benign gynecological conditions was included as control group. All patients underwent HPV-DNA test in the cervix and in the peritoneal cavity simultaneously at time of surgery. 272 patients had cervical and peritoneal HPV-test analyzed. Cervical and peritoneal HPV positivity (PHP) was found in 235 (88.0%) and 78 (28.7%) patients, respectively; the prevalence of PHP was 17.7% in early-stage, 28.8% in locally-advanced (LACC), and 46.6% in the metastatic/persistent/recurrent setting (p=0.001). No control patient was found to have peritoneal HPV infection. Higher frequency of PHP was documented in patients with larger tumor size (p=0.003), presence of cervical HPV 16/18 genotypes (p<0.001), higher number of cervical high-risk (HR)-HPV per patient (p=0.018) and peritoneal carcinomatosis (p<0.001). Multivariate analysis demonstrated that lack of pre-operative cervical conization in early stages (p=0.030), while higher FIGO-stage (p=0.021) and presence of cervical HPV 16/18 (p=0.001) in LACC, were associated with PHP. This is a proof of concept study. A number of potential clinical implications, including prognosis, could be obtained by further studies.
- cervical cancer
- prognostic factors