Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization
- Creators
- Giannini A.
- Di Donato V.
- Sopracordevole F.
- Ciavattini A.
- Ghelardi A.
- Vizza E.
- D'Oria O.
- Simoncini T.
- Plotti F.
- Casarin J.
- Golia D'Auge T.
- Cuccu I.
- Serati M.
- Pinelli C.
- Bergamini A.
- Gardella B.
- Dell'Acqua A.
- Monti E.
- Vercellini P.
- D'Ippolito G.
- Aguzzoli L.
- Dario Mandato V.
- Giannella L.
- Scaffa C.
- Ditto A.
- Falcone F.
- Borghi C.
- Malzoni M.
- Di Giovanni A.
- Salerno M. G.
- Liberale V.
- Contino B.
- Donfrancesco C.
- Desiato M.
- Perrone A. M.
- De Iaco P.
- Ferrero S.
- Sarpietro G.
- Matarazzo M. G.
- Cianci A.
- Cianci S.
- Bosio S.
- Ruisi S.
- Mosca L.
- Tinelli R.
- De Vincenzo R.
- Zannoni G. F.
- Ferrandina G.
- Petrillo M.
- Capobianco G.
- Carlea A.
- Zullo F.
- Muschiato B.
- Palomba S.
- Greggi S.
- Spinillo A.
- Ghezzi F.
- Colacurci N.
- Angioli R.
- Benedetti Panici P.
- Muzii L.
- Scambia G.
- Raspagliesi F.
- Bogani G.
- Others:
- Giannini, A.
- Di Donato, V.
- Sopracordevole, F.
- Ciavattini, A.
- Ghelardi, A.
- Vizza, E.
- D'Oria, O.
- Simoncini, T.
- Plotti, F.
- Casarin, J.
- Golia D'Auge, T.
- Cuccu, I.
- Serati, M.
- Pinelli, C.
- Bergamini, A.
- Gardella, B.
- Dell'Acqua, A.
- Monti, E.
- Vercellini, P.
- D'Ippolito, G.
- Aguzzoli, L.
- Dario Mandato, V.
- Giannella, L.
- Scaffa, C.
- Ditto, A.
- Falcone, F.
- Borghi, C.
- Malzoni, M.
- Di Giovanni, A.
- Salerno, M. G.
- Liberale, V.
- Contino, B.
- Donfrancesco, C.
- Desiato, M.
- Perrone, A. M.
- De Iaco, P.
- Ferrero, S.
- Sarpietro, G.
- Matarazzo, M. G.
- Cianci, A.
- Cianci, S.
- Bosio, S.
- Ruisi, S.
- Mosca, L.
- Tinelli, R.
- De Vincenzo, R.
- Zannoni, G. F.
- Ferrandina, G.
- Petrillo, M.
- Capobianco, G.
- Carlea, A.
- Zullo, F.
- Muschiato, B.
- Palomba, S.
- Greggi, S.
- Spinillo, A.
- Ghezzi, F.
- Colacurci, N.
- Angioli, R.
- Benedetti Panici, P.
- Muzii, L.
- Scambia, G.
- Raspagliesi, F.
- Bogani, G.
Description
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.
Additional details
- URL
- https://hdl.handle.net/11567/1118519
- URN
- urn:oai:iris.unige.it:11567/1118519
- Origin repository
- UNIGE