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 con-founding 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 multi-variate 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.(c) 2021 Elsevier Inc. All rights reserved.
High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes / Bogani, Giorgio; Sopracordevole, Francesco; Di Donato, Violante; Ciavattini, Andrea; Ghelardi, Alessandro; Lopez, Salvatore; Simoncini, Tommaso; Plotti, Francesco; Casarin, Jvan; Serati, Maurizio; Pinelli, Ciro; Valenti, Gaetano; Bergamini, Alice; Gardella, Barbara; Dell'Acqua, Andrea; Monti, Ermelinda; Vercellini, Paolo; Fischetti, Margherita; D'Ippolito, Giovanni; Aguzzoli, Lorenzo; Mandato, Vincenzo D; Carunchio, Paola; Carlinfante, Gabriele; Giannella, Luca; Scaffa, Cono; Falcone, Francesca; Borghi, Chiara; Ditto, Antonino; Malzoni, Mario; Giannini, Andrea; Salerno, Maria Giovanna; Liberale, Viola; Contino, Biagio; Donfrancesco, Cristina; Desiato, Michele; Perrone, Anna Myriam; Dondi, Giulia; De Iaco, Pierandrea; Chiappa, Valentina; Ferrero, Simone; Sarpietro, Giuseppe; Matarazzo, Maria G; Cianci, Antonio; Bosio, Sara; Ruisi, Simona; Guerrisi, Rocco; Brusadelli, Claudia; Mosca, Lavinia; Lagana', Antonio Simone; Tinelli, Raffaele; Signorelli, Mauro; De Vincenzo, Rosa; Zannoni, Gian Franco; Ferrandina, Gabriella; Lovati, Sara; Petrillo, Marco; Dessole, Salvatore; Carlea, Annunziata; Zullo, Fulvio; Angioli, Roberto; Greggi, Stefano; Spinillo, Arsenio; Ghezzi, Fabio; Colacurci, Nicola; Muzii, Ludovico; Benedetti Panici, Pierluigi; Scambia, Giovanni; Raspagliesi, Francesco. - In: GYNECOLOGIC ONCOLOGY. - ISSN 0090-8258. - 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
Bergamini, Alice;
2021-01-01
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 con-founding 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 multi-variate 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.(c) 2021 Elsevier Inc. All rights reserved.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
