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. 2021 Dec;10(23):8310-8319.
doi: 10.1002/cam4.4358. Epub 2021 Oct 21.

Prognostic impact of hepatitis B virus infection in patients with primary cervical cancer

Xiaoyan Feng  1   2 , Huaiwu Lu  3 , Yuan Wei  1   2 , Meimei Guan  3 , Junyi Wang  1   2 , Changhao Liu  3 , Tianran Shen  1   2 , Qingsong Chen  1   2 , Qunxian Rao  3
Affiliations

Prognostic impact of hepatitis B virus infection in patients with primary cervical cancer

Xiaoyan Feng et al. Cancer Med. 2021 Dec.

Abstract

Background: Hepatitis B virus (HBV) infection has been associated with an increased risk of a few malignancies. However, the prognostic impact of HBV infection remains unclear in cervical cancer.

Objective: To explore the association between HBV infection and survival outcomes of patients with primary cervical cancer, using overall survival (OS) and disease-free survival (DFS) as primary endpoints.

Methods: This analysis was performed retrospectively with newly diagnosed cervical cancer patients admitted to the Department of Gynecologic Oncology at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University from June 2013 to October 2019, who were enrolled and followed up. The Kaplan-Meier method and Cox proportional hazard analysis were used to examine the performance of HBV infection in predicting OS and DFS.

Results: Patients were followed up for a median of 37.17 months (95% CI, 34.69-39.65). Among the 695 patients, 87 (12.5%) were serologically positive for hepatitis B surface antigen (HBsAg), and 276 (39.7%) had a prior history of HBV infection. There was no significant difference between HBsAg-positive group and HBsAg-negative patients concerning OS or DFS. Multivariate analysis showed prior HBV infection was an independent favorable prognosticator for OS (HR, 0.335; 95% CI, 0.153-0.0.734; p = 0.006) and DFS (HR, 0.398; 95% CI, 0.208-0.691; p = 0.002).

Conclusion: We provide the first clinical evidence that suggests prior HBV infection as an independent favorable prognostic factor for patients with primary cervical cancer.

Keywords: cervical cancer; hepatitis B virus (HBV); human papillomavirus (HPV); prognosis; surgery.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Prior hepatitis B virus infection Kaplan–Meier graph. (A) OS prognostic survival curve of patients with prior hepatitis B virus infection status. (B) DFS prognostic survival curve of patients with prior hepatitis B virus infection status. (C) OS prognostic survival curve of patients with prior hepatitis B virus infection and HPV infection status. (D) DFS prognostic survival curve of patients with prior hepatitis B virus infection and HPV infection status
FIGURE 2
FIGURE 2
Prior hepatitis B virus infection status in subgroup analysis Kaplan–Meier graph. Kaplan–Meier curves show that Prior hepatitis B virus infection status was associated with favorable survival in patients with age and treatment in subgroup analysis. (E) Overall survival subdivided by prior hepatitis B virus infection in elder. (F) Disease‐free survival subdivided by prior hepatitis B virus infection in elder patients. (G) Overall survival subdivided by prior hepatitis B virus infection in surgery plus radiotherapy patients. (H) Disease‐free survival subdivided by prior hepatitis B virus infection in surgery plus radiotherapy patients
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