Prognosis of HPV-independent, p53-wild-type vulvar squamous cell carcinoma: A systematic review and meta-analysis

IF 4.1 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-09-04 DOI:10.1016/j.ygyno.2025.08.028

Caterina FULGIONE , Frediano INZANI , Antonio RAFFONE , Diego RAIMONDO , Damiano ARCIUOLO , Susanna RONCHI , Deborah MARCHIORI , Roberta MARAGLIANO , Daniele NEOLA , Maria Giovanna VASTARELLA , Luigi COBELLIS , Stefano L.A. ROSA , Gian Franco ZANNONI , Antonio TRAVAGLINO

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引用次数: 0

Abstract

Background

Vulvar squamous cell carcinoma (VSCC) is subdivided into TP53-mutant (TP53^mut) and HPV-associated (HPV⁺). In recent years, a third group unrelated to TP53 mutation or HPV-association (TP53^wt/HPV⁻) has emerged. However, its prognosis is unclear.

Objective

The aim of this study was to define the prognosis of TP53^wt/HPV⁻VSCC through a systematic review and meta-analysis.

Methods

Electronic databases were searched from their inception to February 2025 for studies comparing the prognosis of TP53^wt/HPV⁻ VSCC to that of TP53^mut and HPV⁺ VSCC. Pooled hazard ratios (HR) for recurrence-free survival (RFS) and disease-specific survival (DSS) were calculated, with a significant p-value<0.05.

Results

Six studies were included in the systematic review, while 5 studies with 1355 VSCCs (755 TP53^mut, 302 HPV⁺, 298 TP53^wt/HPV⁻) were included in the meta-analysis. TP53^wt/HPV⁻ VSCC showed significantly better PFS (HR = 0.714; p = 0.022) and DSS (HR = 0.633; p = 0.037) than TP53^mut VSCC and significantly worse PFS (HR = 2.555; p = 0.001) and DSS (HR = 1.973; p = 0.024) than HPV⁺ VSCC.

Conclusions

TP53^wt/HPV⁻ VSCCs constitute a group at intermediate risk, with a prognosis significantly better than TP53^mut VSCC and significantly worse than HPV⁺ VSCC.

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不依赖hpv的p53野生型外阴鳞状细胞癌的预后：系统回顾和荟萃分析

外阴鳞状细胞癌（VSCC）又分为p53突变型（TP53mut）和HPV相关型（HPV+）。近年来，出现了与TP53突变或HPV关联无关的第三组（TP53wt/HPV -）。然而，其预后尚不清楚。目的通过系统回顾和荟萃分析来确定TP53wt/HPV - VSCC的预后。方法检索从建立到2025年2月的电子数据库，比较TP53wt/HPV - VSCC与TP53mut和HPV+ VSCC的预后。计算无复发生存期（RFS）和疾病特异性生存期（DSS）的合并风险比（HR）， p值为0.05。结果6项研究被纳入系统评价，5项研究共1355例VSCCs（755例TP53mut， 302例HPV+， 298例TP53wt/HPV−）被纳入meta分析。TP53wt/HPV - VSCC的PFS （HR = 0.714, p = 0.022）和DSS （HR = 0.633, p = 0.037）明显优于TP53mut VSCC， PFS （HR = 2.555, p = 0.001）和DSS （HR = 1.973, p = 0.024）明显低于HPV+ VSCC。结论stp53wt /HPV - VSCC为中危组，预后明显好于TP53mut VSCC，明显差于HPV+ VSCC。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy