Published online Jun 7, 2020. doi: 10.3748/wjg.v26.i21.2729
Peer-review started: January 30, 2020
First decision: March 15, 2020
Revised: March 18, 2020
Accepted: May 21, 2020
Article in press: May 21, 2020
Published online: June 7, 2020
High-risk human papillomavirus has been suggested as a risk factor for esophageal adenocarcinoma. Tumor human papillomavirus status has been reported to confer a favorable prognosis in esophageal adenocarcinoma. The size of the primary tumor and degree of lymphatic spread determines the prognosis of esophageal carcinomas. Lymph node status has been found to be a predictor of recurrent disease as well as 5-year survival in esophageal malignancies. In human papillomavirus driven cancers, e.g. cervical, anogenital, head and neck cancers, associated lymph nodes with a high viral load suggest metastatic lymph node involvement. Thus, human papillomavirus could potentially be useful as a marker of micro-metastases. To date, there have been no reported studies regarding human papillomavirus involvement in lymph nodes of metastatic esophageal adenocarcinoma. This review highlights the importance of investigating human papillomavirus in lymph node metastasis of esophageal adenocarcinoma based on data derived from other human papillomavirus driven cancers.
Core tip: Esophageal adenocarcinoma (EAC) is one of the fastest growing cancers in the western world. EAC has been associated with high-risk human papillomavirus and has been shown to grant a positive prognosis in EAC. In some human papillomavirus (HPV) driven malignancies (e.g., cervical and head and neck tumors), associated lymph nodes with a high viral load suggest metastatic lymph node involvement. Therefore, HPV is a potential marker of micro-metastases. This review highlights the importance of investigating HPV in lymph node metastasis of EAC based on data derived from other HPV driven malignancies.