Evidence map›Paper›PMID 40448288›Full record

ArticleInternational journal of cancer2025

Prognostic impact of p16 and high-risk HPV DNA in ~1300 patients with vulvar cancer.

Susanne K Kjær, Kirsten Frederiksen, Christina L Rasmussen, Louise T Thomsen, Else M Madsen, Maria B Franzmann, Alexander K Kjær, Lise G Larsen, Nadia V Salinas, Doris Schledermann and 5 more

Abstract read
In one paragraph

Article in International journal of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Susanne K KjærUnit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.ORCID 0000-0002-8347-1398
Kirsten FrederiksenStatistics and Data Analysis, Danish Cancer Institute, Copenhagen, Denmark.ORCID 0000-0001-7919-6613
Christina L RasmussenUnit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.
Louise T ThomsenUnit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.
Else M MadsenDepartment of Pathology, Aarhus University Hospital, Aarhus, Denmark.
Maria B FranzmannDepartment of Pathology, Hvidovre University Hospital, Hvidovre, Denmark.
Alexander K KjærUnit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.
Lise G LarsenDepartment of Pathology, University Hospital of Zealand, Naestved, Denmark.
Nadia V SalinasDepartment of Pathology, Aalborg University Hospital, Aalborg, Denmark.
Doris SchledermannDepartment of Pathology, Lillebaelt Hospital, Vejle, Denmark.
Birgitte H WinbergDepartment of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
Pernille T JensenDepartment of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark.
Dorthe ØrnskovDepartment of Pathology, Odense University Hospital, Odense, Denmark.
Marianne WaldstrømDepartment of Pathology, Aarhus University Hospital, Aarhus, Denmark.
Louise BaandrupUnit of Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.ORCID 0000-0002-5773-5169

Funding

Erik og Susanna Olesens Almenvelgørende FondKræftens Bekæmpelse R276-16413
6 · The paper itself

Abstract

The study aimed to investigate whether vulvar squamous cell carcinoma (VSCC) survival varies by human papillomavirus (HPV) status measured by p16 expression and to determine whether high-risk HPV (hrHPV) DNA detection adds further prognostic information. Our cohort included 1277 women with histologically verified VSCC (1990-2017) categorized according to p16 and hrHPV DNA. Crude survival was estimated using Kaplan-Meier, and differences in restricted mean survival time were estimated in linear regression models. Analyses were stratified by p16 and p16/hrHPV status and stage, and adjustment included age, calendar year, and comorbidity. Overall analysis showed that 5-year survival was 67% (95% CI: 63-71%) and 45% (95% CI: 42-48%) in p16-positive and p16-negative VSCC, respectively. Overall, detection of hrHPV was associated with a 23% (95% CI: 6-40%) improvement in 5-year survival in p16-positive VSCC, whereas hrHPV status did not impact 5-year survival in p16-negative VSCC. In adjusted analysis, the survival difference by p16 status increased with increasing stage with a 26% (95% CI: 4-46%) higher 5-year survival in FIGO IV disease if the tumor was p16-positive compared to p16-negative, corresponding to a restricted mean survival time difference of 18 months in favor of p16 positivity. The largest VSCC cohort to date confirms the beneficial prognostic impact of p16 expression regardless of age and comorbidity and with the greatest impact in women with advanced disease. Classification according to p16 was adequate for p16-negative VSCC, whereas the survival of p16-positive VSCC was higher if hrHPV testing was also positive.

Indexed as

Carcinoma, Squamous CellCyclin-Dependent Kinase Inhibitor p16DNA, ViralPapillomaviridaePapillomavirus InfectionsVulvar NeoplasmsAdultAgedAged, 80 and overFemaleHumansKaplan-Meier EstimateMiddle AgedPrognosisCDKN2A protein, humanCyclin-Dependent Kinase Inhibitor p16DNA, Viralhuman papillomavirusp16survivalvulvar cancer

Identifiers

PMID40448288
PMCPMC12334900

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.