Updated May 2026
HPV-independent cervical adenocarcinomas and squamous cell carcinomas are biologically distinct entities associated with older age at diagnosis, advanced stage, and significantly worse prognosis. In retrospective analyses, these tumours exhibit poor response to standard chemoradiotherapy and have higher recurrence rates14. HPV independent carcinoma cases should be reviewed in multidisciplinary conference.
For early-stage disease, radical hysterectomy with lymph node dissection is recommended. Fertility-sparing procedures are not advised. Extended staging procedures such as omentectomy may be considered.
In locally advanced disease, concurrent chemoradiotherapy remains standard, but careful response monitoring is essential given poor response rates. Early salvage surgery should be considered in cases with incomplete response. Additional biomarker testing may be considered to identify potential candidates for immune checkpoint inhibitors (PD-L1 CPS score IHC) or anti-HER2 targeted therapies (HER2 IHC). Clinical trial enrolment should be encouraged in this setting.
