HPV and Esophageal Cancer: Survival Impact 

A study published in JAMA found that patients with Barrett’s high-grade dysplasia or Esophageal Cancer (EAC) who HPV-positive have better outcomes than those who are HPV-negative peers. 

The retrospective case-control study included 142 patients with HGD/EAC from secondary and tertiary referral centers. Thirty-seven patients were HPV positive, and 105 were HPV negative. Researchers tested pretreatment biopsies for HPV DNA determination via polymerase chain reaction, in situ hybridization for E6 and E7 messenger RNA, and immunohistochemistry for the proteins p16INK4A and p53. 

HPV Linked to Esophageal Cancer Outcomes (MedPage Today) — Better disease-free and overall survival in patients with HPV-positive disease https://t.co/g254cFwxVU

— Healthy News Daily (@eHealthyDaily) August 4, 2018

Disease-free survival was improved in patients who were HPV-positive (40.3 vs. 24.1 months; P=0.003). Overall survival was also improved in HPV-positive patients (43.7 vs. 29.8 months; P=0.009). Recurrence or progression was reduced in the HPV-positive cohort (24.3% vs 58.1%; difference, −33.8%; 95% CI, −50.5% to −17.0%; P < .001) as was distant metastasis (8.1% vs 27.6%; difference, −19.5%; 95% CI, −31.8% to −7.2%; P = .02) and death from esophageal adenocarcinoma (13.5% vs 36.2%; difference, −22.7%; 95% CI, −37.0% to −8.3%; P = .01). Positive results for HPV and transcriptionally active virus were both associated with a superior DFS (hazard ratio [HR], 0.33; 95% CI, 0.16-0.67; P = .002 and HR, 0.44; 95% CI, 0.22-0.88; P = .02, respectively [log-rank test]). Positivity for E6 and E7 mRNA, high p16INK4A expression, and low p53 expression were not associated with improved DFS. On multivariate analysis, superior DFS was demonstrated for HPV (HR, 0.39; 95% CI, 0.18-0.85; P = .02), biologically active virus (HR, 0.36; 95% CI, 0.15-0.86; P = .02), E6 and E7 mRNA (HR, 0.36; 95% CI, 0.14-0.96; P = .04), and high p16 expression (HR, 0.49; 95% CI, 0.27-0.89; P = .02). 

Read about an HPV test that identifies cervical cancer earlier than Pap test. 

Read about an HPV vaccine that protects against cervical cancer. 

Survival in High-grade Barrett Dysplasia and Esophageal Cancer With or Without HPV https://t.co/KpgSXfy09l

— Raymond DuBois (@Rndubois) August 6, 2018

Source: JAMA