High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes
- Creators
- 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.
- Others:
- 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.
Description
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.
Additional details
- URL
- https://hdl.handle.net/11567/1122078
- URN
- urn:oai:iris.unige.it:11567/1122078
- Origin repository
- UNIGE