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Consecutive patients with newly diagnosed or recurrent\/persistent CC, between March 2019 and April 2020, were included. A group of patients undergoing surgery for benign gynecological conditions was included as control group. All patients underwent HPV\u2010DNA test in the cervix and in the peritoneal cavity simultaneously at time of surgery. Two\u2010hundred seventy\u2010two patients had cervical and peritoneal HPV test analyzed. Cervical and peritoneal HPV positivity (PHP) was found in 235 (88.0%) and 78 (28.7%) patients, respectively; the prevalence of PHP was 17.7% in early stage, 28.8% in locally advanced cervical cancer (LACC) and 46.6% in the metastatic\/persistent\/recurrent setting (<jats:italic>P<\/jats:italic> =\u2009.001). No control patient was found to have peritoneal HPV infection. Higher frequency of PHP was documented in patients with larger tumor size (<jats:italic>P<\/jats:italic> =\u2009.003), presence of cervical HPV 16\/18 genotypes (<jats:italic>P<\/jats:italic> &lt;\u2009.001), higher number of cervical high\u2010risk (HR)\u2010HPV per patient (<jats:italic>P<\/jats:italic> =\u2009.018) and peritoneal carcinomatosis (<jats:italic>P<\/jats:italic> &lt;\u2009.001). Multivariate analysis demonstrated that lack of preoperative cervical conization in early stages (<jats:italic>P<\/jats:italic> =\u2009.030), while higher International Federation of Gynecology and Obstetrics (FIGO) stage (<jats:italic>P<\/jats:italic> =\u2009.021) and presence of cervical HPV 16\/18 (<jats:italic>P<\/jats:italic> =\u2009.001) in LACC, was associated with PHP. This is a proof\u2010of\u2010concept study. A number of potential clinical implications, including prognosis, could be obtained by further studies.<\/jats:p>","DOI":"10.1002\/ijc.33380","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T17:30:40Z","timestamp":1604597440000},"page":"1197-1207","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Peritoneal <scp>HPV\u2010DNA<\/scp> test in cervical cancer (PIONEER study): A proof of concept"],"prefix":"10.1002","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1727-904X","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Bizzarri","sequence":"first","affiliation":[{"name":"Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica Fondazione Policlinico Universitario A. 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