Prognostic Associations between HPV-16 and HPV-18 in cervical cancer: a systematic review

Cervical cancer is a major health problem for women worldwide and is most commonly caused by high-risk human papillomavirus (HPV) infections, particularly HPV-16 and HPV-18. This systematic review examines 13 studies that investigated how these two HPV types affect survival outcomes in cervical cancer patients, including overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS). Across multiple studies, HPV-16 was generally associated with better survival outcomes, especially in patients with advanced-stage disease. This may reflect the increased sensitivity of HPV-16-positive tumors to treatments such as chemoradiotherapy. In contrast, HPV-18 was consistently linked to poorer prognosis, particularly in early-stage cervical cancer and adenocarcinoma, with higher rates of recurrence and mortality. Several molecular markers, including p16 overexpression, HPV DNA methylation, and E6 oncoprotein expression, further helped explain differences in patient outcomes. Overall, these findings highlight the importance of HPV genotyping for predicting prognosis and guiding personalized cervical cancer treatment.