Background: Cervical dysplasia persistence/recurrence has a great impact on women's health and quality of life. In this study, we investigated whether a prognostic nomogram may improve risk assessment after primary conization. Methods: This is a retrospective multi-institutional study based on charts of consecutive patients undergoing conization between 1 January 2010 and 31 December 2014. A nomogram assessing the importance of different variables was built. A cohort of patients treated between 1 January 2015 and 30 June 2016 was used to validate the nomogram. Results: A total of 2966 patients undergoing primary conization were analyzed. The median (range) patient age was 40 (18-89) years. At 5-year of follow-up, 6% of patients (175/2966) had developed a persistent/recurrent cervical dysplasia. Median (range) recurrence-free survival was 18 (5-52) months. Diagnosis of CIN3, presence of HR-HPV types, positive endocervical margins, HPV persistence, and the omission of HPV vaccination after conization increased significantly and independently of the risk of developing cervical dysplasia persistence/recurrence. A nomogram weighting the impact of all variables was built with a C-Index of 0.809. A dataset of 549 patients was used to validate the nomogram, with a C-index of 0.809. Conclusions: The present nomogram represents a useful tool for counseling women about their risk of persistence/recurrence after primary conization. HPV vaccination after conization is associated with a reduced risk of CIN2+.
Development of a Nomogram Predicting the Risk of Persistence/Recurrence of Cervical Dysplasia / Bogani, Giorgio; Lalli, Luca; Sopracordevole, Francesco; Ciavattini, Andrea; Ghelardi, Alessandro; Simoncini, Tommaso; Plotti, Francesco; Casarin, Jvan; Serati, Maurizio; Pinelli, Ciro; Bergamini, Alice; Gardella, Barbara; Dell'Acqua, Andrea; Monti, Ermelinda; Vercellini, Paolo; Palaia, Innocenza; Perniola, Giorgia; Fischetti, Margherita; Santangelo, Giusi; Fracassi, Alice; D'Ippolito, Giovanni; Aguzzoli, Lorenzo; Mandato, Vincenzo Dario; Giannella, Luca; Scaffa, Cono; Falcone, Francesca; Borghi, Chiara; Malzoni, Mario; Giannini, Andrea; Salerno, Maria Giovanna; Liberale, Viola; Contino, Biagio; Donfrancesco, Cristina; Desiato, Michele; Perrone, Anna Myriam; Dondi, Giulia; 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; Dessiole, Salvatore; 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; Di Donato, Violante. - In: VACCINES. - ISSN 2076-393X. - 10:4(2022), p. 579. [10.3390/vaccines10040579]
Development of a Nomogram Predicting the Risk of Persistence/Recurrence of Cervical Dysplasia
Bergamini, Alice;
2022-01-01
Abstract
Background: Cervical dysplasia persistence/recurrence has a great impact on women's health and quality of life. In this study, we investigated whether a prognostic nomogram may improve risk assessment after primary conization. Methods: This is a retrospective multi-institutional study based on charts of consecutive patients undergoing conization between 1 January 2010 and 31 December 2014. A nomogram assessing the importance of different variables was built. A cohort of patients treated between 1 January 2015 and 30 June 2016 was used to validate the nomogram. Results: A total of 2966 patients undergoing primary conization were analyzed. The median (range) patient age was 40 (18-89) years. At 5-year of follow-up, 6% of patients (175/2966) had developed a persistent/recurrent cervical dysplasia. Median (range) recurrence-free survival was 18 (5-52) months. Diagnosis of CIN3, presence of HR-HPV types, positive endocervical margins, HPV persistence, and the omission of HPV vaccination after conization increased significantly and independently of the risk of developing cervical dysplasia persistence/recurrence. A nomogram weighting the impact of all variables was built with a C-Index of 0.809. A dataset of 549 patients was used to validate the nomogram, with a C-index of 0.809. Conclusions: The present nomogram represents a useful tool for counseling women about their risk of persistence/recurrence after primary conization. HPV vaccination after conization is associated with a reduced risk of CIN2+.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
