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 / Bogani G.; Sopracordevole F.; Di Donato V.; Ciavattini A.; Ghelardi A.; Lopez S.; Simoncini T.; Plotti F.; Casarin J.; Serati M.; Pinelli C.; Valenti G.; Bergamini A.; Gardella B.; Dell'acqua A.; Monti E.; Vercellini P.; Fischetti M.; D'ippolito G.; Aguzzoli L.; Mandato V.D.; Carunchio P.; Carlinfante G.; Giannella L.; Scaffa C.; Falcone F.; Borghi C.; Ditto A.; Malzoni M.; Giannini A.; Salerno M.G.; Liberale V.; Contino B.; Donfrancesco C.; Desiato M.; Perrone A.M.; Dondi G.; De Iaco P.; Chiappa V.; Ferrero S.; Sarpietro G.; Matarazzo M.G.; Cianci A.; Bosio S.; Ruisi S.; Guerrisi R.; Brusadelli C.; Mosca L.; Lagana' A.S.; Tinelli R.; Signorelli M.; De Vincenzo R.; Zannoni G.F.; Ferrandina G.; Lovati S.; Petrillo M.; Dessole S.; Carlea A.; Zullo F.; Angioli R.; Greggi S.; Spinillo A.; Ghezzi F.; Colacurci N.; Muzii L.; Benedetti Panici P.; Scambia G.; Raspagliesi F.. - In: GYNECOLOGIC ONCOLOGY. - ISSN 0090-8258. - ELETTRONICO. - 161:1(2021), pp. 173-178. [10.1016/j.ygyno.2021.01.020]
High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes
Perrone A. M.;Dondi G.;De Iaco P.;Cianci A.;Bosio S.;Mosca L.;Signorelli M.;Petrillo M.;Zullo F.;Ghezzi F.;
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
