The objective of this work is to assess the 5-year outcomes of patients undergoing conization for high-grade cervical lesions that simultaneously present as risk factors in the persistence of HPV infection and the positivity of surgical resection margins. This is a retrospective study evaluating patients undergoing conization for high-grade cervical lesions. All patients included had both positive surgical margins and experienced HPV persistence at 6 months. Associations were evaluated with Cox proportional hazard regression and summarized using hazard ratio (HR). The charts of 2966 patients undergoing conization were reviewed. Among the whole population, 163 (5.5%) patients met the inclusion criteria, being at high risk due to the presence of positive surgical margins and experiencing HPV persistence. Of 163 patients included, 17 (10.4%) patients developed a CIN2+ recurrence during the 5-year follow-up. Via univariate analyses, diagnosis of CIN3 instead of CIN2 (HR: 4.88 (95%CI: 1.10, 12.41); p = 0.035) and positive endocervical instead of ectocervical margins (HR: 6.44 (95%CI: 2.80, 9.65); p < 0.001) were associated with increased risk of persistence/recurrence. Via multivariate analyses, only positive endocervical instead of ectocervical margins (HR: 4.56 (95%CI: 1.23, 7.95); p = 0.021) were associated with worse outcomes. In this high-risk group, positive endocervical margins is the main risk factor predicting 5-year recurrence.

Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization

Perrone, Anna Myriam;De Iaco, Pierandrea;
2023

Abstract

The objective of this work is to assess the 5-year outcomes of patients undergoing conization for high-grade cervical lesions that simultaneously present as risk factors in the persistence of HPV infection and the positivity of surgical resection margins. This is a retrospective study evaluating patients undergoing conization for high-grade cervical lesions. All patients included had both positive surgical margins and experienced HPV persistence at 6 months. Associations were evaluated with Cox proportional hazard regression and summarized using hazard ratio (HR). The charts of 2966 patients undergoing conization were reviewed. Among the whole population, 163 (5.5%) patients met the inclusion criteria, being at high risk due to the presence of positive surgical margins and experiencing HPV persistence. Of 163 patients included, 17 (10.4%) patients developed a CIN2+ recurrence during the 5-year follow-up. Via univariate analyses, diagnosis of CIN3 instead of CIN2 (HR: 4.88 (95%CI: 1.10, 12.41); p = 0.035) and positive endocervical instead of ectocervical margins (HR: 6.44 (95%CI: 2.80, 9.65); p < 0.001) were associated with increased risk of persistence/recurrence. Via multivariate analyses, only positive endocervical instead of ectocervical margins (HR: 4.56 (95%CI: 1.23, 7.95); p = 0.021) were associated with worse outcomes. In this high-risk group, positive endocervical margins is the main risk factor predicting 5-year recurrence.
2023
Giannini, Andrea; Di Donato, Violante; Sopracordevole, Francesco; Ciavattini, Andrea; Ghelardi, Alessandro; Vizza, Enrico; D'Oria, Ottavia; Simoncini, Tommaso; Plotti, Francesco; Casarin, Jvan; Golia D'Augè, Tullio; Cuccu, Ilaria; Serati, Maurizio; Pinelli, Ciro; Bergamini, Alice; Gardella, Barbara; Dell'Acqua, Andrea; Monti, Ermelinda; Vercellini, Paolo; D'Ippolito, Giovanni; Aguzzoli, Lorenzo; Dario Mandato, Vincenzo; Giannella, Luca; Scaffa, Cono; Ditto, Antonino; Falcone, Francesca; Borghi, Chiara; Malzoni, Mario; Di Giovanni, Alessandra; Salerno, Maria Giovanna; Liberale, Viola; Contino, Biagio; Donfrancesco, Cristina; Desiato, Michele; Perrone, Anna Myriam; De Iaco, Pierandrea; Ferrero, Simone; Sarpietro, Giuseppe; Matarazzo, Maria G; Cianci, Antonio; Cianci, Stefano; Bosio, Sara; Ruisi, Simona; Mosca, Lavinia; Tinelli, Raffaele; De Vincenzo, Rosa; Zannoni, Gian Franco; Ferrandina, Gabriella; Petrillo, Marco; Capobianco, Giampiero; Carlea, Annunziata; Zullo, Fulvio; Muschiato, Barbara; Palomba, Stefano; Greggi, Stefano; Spinillo, Arsenio; Ghezzi, Fabio; Colacurci, Nicola; Angioli, Roberto; Benedetti Panici, Pierluigi; Muzii, Ludovico; Scambia, Giovanni; Raspagliesi, Francesco; Bogani, Giorgio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/955921
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