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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China
  • Female
  • Hepatitis B / complications*
  • Hepatitis B / mortality
  • Humans
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Uterine Cervical Neoplasms / complications*
  • Uterine Cervical Neoplasms / mortality