Objective: To evaluate the outcomes of high-risk (HR) HPV-positive and -negative women affected by high-grade cervical dysplasia. Methods: This is a retrospective multi-institutional study. Medical records of consecutive patients with high-grade cervical dysplasia undergoing conization between 2010 and 2014 were retrieved. All patients included had at least 5 years of follow-up. A propensity-score matching was adopted in order to reduce the presence of confounding factors between groups. Kaplan-Meir and Cox hazard models were used to estimate 5-year outcomes. Results: Overall, data of 2966 women, affected by high-grade cervical dysplasia were reviewed. The study population included 1478 (85%) and 260 (15%) women affected by HR-HPV-positive and HR-HPV-negative high-grade cervical dysplasia. The prevalence of CIN2 and CIN3 among the HR-HPV-positive and -negative cohort was similar (p = 0.315). Patients with HR-HPV-positive high-grade cervical dysplasia were at higher risk of 5-year recurrence (after primary conization) that HR-HPV-negative patients (p < 0.001, log-rank test). Via multivariate analysis, HR-HPV-negative women were at low risk of recurrence (HR: 1.69 (95%CI: 1.05, 4.80); p = 0.018, Cox Hazard model). A propensity-score matched comparison was carried out in order to reduce biases that are related to the retrospective study design. In comparison to HR-HPV-negative patients, thosewith HR-HPV-positive CIN3 was associate with a 8-fold increase in the risk of recurrence (p < 0.001, log-rank test). Conclusions: HR-HPV-negative high-grade cervical dysplasia is not uncommon, accounting for 15% of our study population. Those patients experience more favorable outcomes than patients with documented HR-HPV infection(s). Further prospective studies are needed to corroborate our data.

High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes / G. Bogani, F. Sopracordevole, V. Di Donato, A. Ciavattini, A. Ghelardi, S. Lopez, T. Simoncini, F. Plotti, J. Casarin, M. Serati, C. Pinelli, G. Valenti, A. Bergamini, B. Gardella, A. Dell'acqua, E. Monti, P. Vercellini, M. Fischetti, G. D'ippolito, L. Aguzzoli, V.D. Mandato, P. Carunchio, G. Carlinfante, L. Giannella, C. Scaffa, F. Falcone, C. Borghi, A. Ditto, M. Malzoni, A. Giannini, M.G. Salerno, V. Liberale, B. Contino, C. Donfrancesco, M. Desiato, A.M. Perrone, G. Dondi, P. De Iaco, V. Chiappa, S. Ferrero, G. Sarpietro, M.G. Matarazzo, A. Cianci, S. Bosio, S. Ruisi, R. Guerrisi, C. Brusadelli, L. Mosca, A.S. Lagana', R. Tinelli, M. Signorelli, R. De Vincenzo, G.F. Zannoni, G. Ferrandina, S. Lovati, M. Petrillo, S. Dessole, A. Carlea, F. Zullo, R. Angioli, S. Greggi, A. Spinillo, F. Ghezzi, N. Colacurci, L. Muzii, P. Benedetti Panici, G. Scambia, F. Raspagliesi. - In: GYNECOLOGIC ONCOLOGY. - ISSN 0090-8258. - (2021). [Epub ahead of print] [10.1016/j.ygyno.2021.01.020]

High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes

A. Dell'acqua;E. Monti;P. Vercellini;S. Bosio;S. Ruisi;
2021

Abstract

Objective: To evaluate the outcomes of high-risk (HR) HPV-positive and -negative women affected by high-grade cervical dysplasia. Methods: This is a retrospective multi-institutional study. Medical records of consecutive patients with high-grade cervical dysplasia undergoing conization between 2010 and 2014 were retrieved. All patients included had at least 5 years of follow-up. A propensity-score matching was adopted in order to reduce the presence of confounding factors between groups. Kaplan-Meir and Cox hazard models were used to estimate 5-year outcomes. Results: Overall, data of 2966 women, affected by high-grade cervical dysplasia were reviewed. The study population included 1478 (85%) and 260 (15%) women affected by HR-HPV-positive and HR-HPV-negative high-grade cervical dysplasia. The prevalence of CIN2 and CIN3 among the HR-HPV-positive and -negative cohort was similar (p = 0.315). Patients with HR-HPV-positive high-grade cervical dysplasia were at higher risk of 5-year recurrence (after primary conization) that HR-HPV-negative patients (p < 0.001, log-rank test). Via multivariate analysis, HR-HPV-negative women were at low risk of recurrence (HR: 1.69 (95%CI: 1.05, 4.80); p = 0.018, Cox Hazard model). A propensity-score matched comparison was carried out in order to reduce biases that are related to the retrospective study design. In comparison to HR-HPV-negative patients, thosewith HR-HPV-positive CIN3 was associate with a 8-fold increase in the risk of recurrence (p < 0.001, log-rank test). Conclusions: HR-HPV-negative high-grade cervical dysplasia is not uncommon, accounting for 15% of our study population. Those patients experience more favorable outcomes than patients with documented HR-HPV infection(s). Further prospective studies are needed to corroborate our data.
CIN; Conization; HPV; Negative; Positive
Settore MED/40 - Ginecologia e Ostetricia
2021
26-gen-2021
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/810937
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