Association Between Pre-Treatment HPV Genotype and Survival in Cervical Cancer: Insights From a Prospective Cohort

Abstract

<title>Abstract</title> <bold>Purpose</bold>: To assess the prevalence of human papillomavirus (HPV) genotypes in cervical cancer (CC) and evaluate their association with survival outcomes and treatment response. <bold>Methods</bold>: This was a prospective observational cohort study including 229 CC patients diagnosed between 2010 and 2019. HPV genotyping was performed using the HybriSpot24™ platform in 84 tumor samples. Patients were treated and followed in a tertiary referral hospital. Primary outcomes included overall survival (OS), disease-free survival (DFS), and treatment response. Group comparisons were conducted using Kaplan-Meier and Cox regression models. Statistical significance was set at p &lt;0.05. <bold>Results</bold>: HPV DNA was detected in 91.67% of tumors, with HPV 16 being the most prevalent genotype (30.71%). HPV-positive patients had significantly longer OS than HPV-negative patients (difference: 26.1 months; 95% CI: 16.5–35.7; p &lt;0.0001). No significant OS difference was observed between HPV 16 and HPV 18 (difference: 3.3 months; 95% CI: -7.6 to 14.1; p = 0.589). Patients with multiple HR-HPV infections had better OS (64.6 vs. 38.5 months; p = 0.047) and DFS (64.6 vs. 30.31 months; p = 0.017), particularly in early-stage disease. <bold>Conclusions</bold>: HPV positivity was associated with improved OS in CC. Multiple HR-HPV infections correlated with enhanced survival and treatment response, especially in early stages. These findings support the prognostic relevance of HPV genotyping in cervical cancer.