Evidence map›Paper›PMID 27210818›Full record

ArticleGynecologic oncology2016

Prognostic importance of human papillomavirus (HPV) and p16 positivity in squamous cell carcinoma of the vulva treated with radiotherapy.

Larissa J Lee, Brooke Howitt, Paul Catalano, Cynthia Tanaka, Rita Murphy, Nicole Cimbak, Rebecca DeMaria, Paula Bu, Christopher Crum, Neil Horowitz and 2 more

Abstract read
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In one paragraph

Article in Gynecologic oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 1 pooled it
11.8field-weighted citation impact, top 1% of its field
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

35 citing papers in PubMed, 1 synthesis or guideline pooled it, 111 citations in OpenAlex.

  1. Pooled it
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  4. Vulvar Squamous Cell Carcinoma: Scientific Progress and Impacts to Pathology Practice.International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2026
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  7. New histopathological and molecular findings in gynecological cancers.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Larissa J LeeDepartment of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: llee@lroc.harvard.edu.
Brooke HowittDepartment of Pathology, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Paul CatalanoDepartment of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Cynthia TanakaDepartment of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.
Rita MurphyDepartment of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.
Nicole CimbakDepartment of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.
Rebecca DeMariaDepartment of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.
Paula BuDepartment of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.
Christopher CrumDepartment of Pathology, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Neil HorowitzDepartment of Gynecologic Oncology, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Ursula MatulonisDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Akila N ViswanathanDepartment of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
Brigham and Women's Hospital · USHarvard University · USDana-Farber Cancer Institute · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveHPV status is an important prognostic factor for patients with oropharyngeal, anal and cervical cancers treated with radiotherapy. This study evaluates the association between HPV and p16 status and outcome in a radiation-treated cohort with vulvar squamous cell carcinoma (SCC).

methodsPatients with vulvar SCC who received radiotherapy with or without surgical resection between 1985 and 2011 were identified retrospectively. Immunostaining for p16 and multiplex PCR for HPV genotyping were performed using archival tumor tissue from 57 patients. Actuarial estimates of PFS, OS and in-field recurrence were calculated using the Kaplan-Meier method. Cox proportional hazards models were used for multivariable analysis. Median follow-up was 58months among the 57 patients with an available tumor specimen.

resultsHPV prevalence was implied in 37% by (diffuse linear) p16 immunostaining and confirmed in 27% by HPV PCR with good agreement (κ=0.7). HPV-16 was identified in 80% of HPV-positive tumors. Women with p16-positive tumors had significantly higher 5-year PFS (65% vs. 16%, p<0.01) and OS (65% vs. 22%, p=0.01) rates, as well as lower in-field relapse rates (19% vs. 75%, p<0.01) compared to those with p16-negative disease. On multivariable analysis adjusted for age and stage, p16 positivity was significantly associated with better PFS (HR 0.4, 95% CI 0.2-0.9) and lower rates of in-field relapse (HR 0.2, 95% CI 0.06-0.6). Results were similar when analyzed by HPV DNA status.

conclusionIn this study, the presence of HPV or its surrogate of p16 immunostaining was an independent prognostic factor for in-field relapse and survival in women with vulvar SCC treated with radiotherapy. This finding warrants validation in larger cohorts or the prospective setting.

Indexed as

AdultAgedAged, 80 and overCarcinoma, Squamous CellCohort StudiesCyclin-Dependent Kinase Inhibitor p16Disease-Free SurvivalDNA, ViralFemaleHumansKaplan-Meier EstimateMiddle AgedPapillomaviridaePapillomavirus InfectionsRetrospective StudiesTreatment OutcomeCDKN2A protein, humanCyclin-Dependent Kinase Inhibitor p16DNA, ViralHuman papillomavirusp16RadiotherapyVulvar cancer

Identifiers

PMID27210818
OpenAlexW2395391304

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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 OpenQuestion graph.