Objective: Using highly sensitive polymerase chain reaction (PCR) techniques, we reanalysed all cervical carcinomas (CCs) found to be human papillomavirus (HPV)‐negative by Hybrid Capture 2 (HC2) to determine the prevalence of true HPV‐negativity. We also evaluated the characteristics of the patients with tumours with confirmed HPV‐negativity.Design: Observational study.Setting: Barcelona, Spain.Population: A cohort of 136 women with CC (32 adenocarcinomas, 104 squamous cell carcinomas) who had pre‐treatment HC2 testing.Methods: All negative cases were reanalysed and genotyped for HPV using three PCR assays (SPF10, GP5+/6+ and E7‐specific assay).Main outcome measures: Percentage of confirmed HPV‐negative and HPV‐positive tumours. Clinicopathological features and disease‐free survival (DFS) and overall survival (OS) of both groups.Results: Fourteen of 136 women (10.2%) were negative for HPV by HC2. After reanalysis by PCR‐based techniques only 8/136 (5.8%) tumours were confirmed as HPV‐negative, whereas in six cases different HPVs were identified [HPV–11, −16 (two tumours), −18, −45, and −68]. Confirmed HPV‐negativity was more frequent in adenocarcinomas than in squamous cell carcinomas (5/32, 15.6% versus 3/104, 2.9%, respectively; P = 0.017). Patients with CCs with confirmed HPV‐negativity had significantly worse DFS than women with HPV‐positive tumours [51.9 months (95% CI 12.2–91.7 months) versus 109.9 months (95% CI 98.2–121.5 months); P = 0.010]. In the multivariate analysis HPV‐negativity and International Federation of Gynecology and Obstetrics (FIGO) staging were associated with increased risk of progression and mortality.Conclusions: An HC2‐negative result is an uncommon finding in women with CC, but in almost half of these cases HPVs are identified by more sensitive techniques. CCs with confirmed HPV‐negativity are more frequently adenocarcinomas, and seem to be associated with worse DFS.

Introduction: Treatment for advanced ovarian cancer (AOC) comprises cytoreductive surgery combined with chemotherapy. Multimodal prehabilitation programmes before surgery have demonstrated efficacy in postoperative outcomes in non-gynaecological surgeries. However, the viability and effects of these programmes on patients with AOC are unknown. We aimed to evaluate the feasibility and postoperative impact of a multimodal prehabilitation programme in AOC patients undergoing surgery. Methods: This single-centre, before-and-after intervention pilot study included 34 patients in two cohorts: the prehabilitation cohort prospectively included 15 patients receiving supervised exercise, nutritional optimisation, and psychological preparation from December 2019 to January 2021; the control cohort included 19 consecutive patients between January 2018 and November 2019. Enhanced Recovery After Surgery guidelines were followed. Results: The overall adherence to the multimodal prehabilitation programme was 80%, with 86.7% adherence to exercise training, 100% adherence to nutritional optimisation, and 80% adherence to psychological preparation. The median hospital stay was shorter in the prehabilitation cohort (5 (IQR, 4–6) vs. 7 days (IQR, 5–9) in the control cohort, p = 0.04). Differences in postoperative complications using the comprehensive complication index (CCI) were not significant (CCI score: 9.3 (SD 12.12) in the prehabilitation cohort vs. 16.61 (SD 16.89) in the control cohort, p = 0.08). The median time to starting chemotherapy was shorter in the prehabilitation cohort (25 (IQR, 23–25) vs. 35 days (IQR, 28–45) in the control cohort, p = 0.03). Conclusions: A multimodal prehabilitation programme before cytoreductive surgery is feasible in AOC patients with no major adverse effects, and results in significantly shorter hospital stays and time to starting chemotherapy.