TY - JOUR
T1 - Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison.
AU - Bogani, Giorgio
AU - Raspagliesi, Francesco
AU - Sopracordevole, Francesco
AU - Ciavattini, Andrea
AU - Ghelardi, Alessandro
AU - Simoncini, Tommaso
AU - Petrillo, Marco
AU - Plotti, Francesco
AU - Lopez, Salvatore
AU - Casarin, Jvan
AU - Serati, Maurizio
AU - Pinelli, Ciro
AU - Valenti, Gaetano
AU - Bergamini, Alice
AU - Gardella, Barbara
AU - Dell'Acqua, Andrea
AU - Monti, Ermelinda
AU - Vercellini, Paolo
AU - D'ippolito, Giovanni
AU - Aguzzoli, Lorenzo
AU - Mandato, Vincenzo D.
AU - Carunchio, Paola
AU - Carlifante, Gabriele
AU - Gianella, Luca
AU - Scaffa, Cono
AU - Falcone, Francesca
AU - Ferla, Stefano
AU - Borghi, Chiara
AU - Ditto, Antonino
AU - Malzoni, Mario
AU - Giannini, Andrea
AU - Salerno, Maria Giovanna
AU - Liberale, Viola
AU - Contino, Biagio
AU - Donfrancesco, Cristina
AU - Desiato, Michele
AU - Perrone, Anna Myriam
AU - Dondi, Giulia
AU - De Iaco, Pierandrea
AU - Leone Roberti Maggiore, Umberto
AU - Signorelli, Mauro
AU - Chiappa, Valentina
AU - Ferrero, Simone
AU - Sarpietro, Giuseppe
AU - Matarazzo, Maria G.
AU - Cianci, Antonio
AU - Bocio, Sara
AU - Ruisi, Simona
AU - Guerrisi, Rocco
AU - Brusadelli, Claudia
AU - Mosca, Lavinia
AU - Tinelli, Raffaele
AU - De Vincenzo, Rosa
AU - Zannoni, Gian Franco
AU - Ferrandina, Gabriella
AU - Dessole, Salvatore
AU - Angioli, Roberto
AU - Greggi, Stefano
AU - Spinillo, Arsenio
AU - Ghezzi, Fabio
AU - Colacurci, Nicola
AU - Fischetti, Margherita
AU - Carlea, Annunziata
AU - Zullo, Fulvio
AU - Muzii, Ludovico
AU - Scambia, Giovanni
AU - Benedetti Panici, Pierluigi
AU - Di Donato, Violante
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Background: Primary prevention through vaccination is a prophylactic approach aiming to reduce the risk of developing human papillomavirus (HPV)-related lesions. No mature and long-term data supported the adoption of vaccination in women undergoing conization. Methods: This is a retrospective multi-institutional study. Charts of consecutive patients undergoing conization between 2010 and 2014 were collected. All patients included had at least 5 years of follow-up. We compared outcomes of patients undergoing conization plus vaccination and conization alone. A propensity-score matching algorithm was applied in order to reduce allocation biases. The risk of developing recurrence was estimated using Kaplan-Meir and Cox hazard models. Results: Overall, charts of 1914 women were analyzed. The study group included 116 (6.1 and 1798 (93.9 women undergoing conization plus vaccination and conization alone, respectively. Five-year recurrence rate was 1.7n = 2) and 5.7n = 102) after conization plus vaccination and conization alone, respectively (p = 0.068). After the application of a propensity-score matching, we selected 100 patients undergoing conization plus vaccination and 200 patients undergoing conization alone. The crude number of recurrences was 2 (2 and 11 (5.5 for patients undergoing conization plus vaccination and conization alone, respectively (p = 0.231). Vaccination had no impact on persistent lesions (no negative examination between conization and new cervical dysplasia; p = 0.603), but reduced the risk of recurrent disease (patients who had at least one negative examination between conization and the diagnosis of recurrent cervical dysplasia; p = 0.031). Conclusions: Patients having vaccination experience a slightly lower risk of recurrence than women who had not, although not statistically significantly different. Further evidence is needed to assess the cost effectiveness of adopting vaccination in this setting.
AB - Background: Primary prevention through vaccination is a prophylactic approach aiming to reduce the risk of developing human papillomavirus (HPV)-related lesions. No mature and long-term data supported the adoption of vaccination in women undergoing conization. Methods: This is a retrospective multi-institutional study. Charts of consecutive patients undergoing conization between 2010 and 2014 were collected. All patients included had at least 5 years of follow-up. We compared outcomes of patients undergoing conization plus vaccination and conization alone. A propensity-score matching algorithm was applied in order to reduce allocation biases. The risk of developing recurrence was estimated using Kaplan-Meir and Cox hazard models. Results: Overall, charts of 1914 women were analyzed. The study group included 116 (6.1 and 1798 (93.9 women undergoing conization plus vaccination and conization alone, respectively. Five-year recurrence rate was 1.7n = 2) and 5.7n = 102) after conization plus vaccination and conization alone, respectively (p = 0.068). After the application of a propensity-score matching, we selected 100 patients undergoing conization plus vaccination and 200 patients undergoing conization alone. The crude number of recurrences was 2 (2 and 11 (5.5 for patients undergoing conization plus vaccination and conization alone, respectively (p = 0.231). Vaccination had no impact on persistent lesions (no negative examination between conization and new cervical dysplasia; p = 0.603), but reduced the risk of recurrent disease (patients who had at least one negative examination between conization and the diagnosis of recurrent cervical dysplasia; p = 0.031). Conclusions: Patients having vaccination experience a slightly lower risk of recurrence than women who had not, although not statistically significantly different. Further evidence is needed to assess the cost effectiveness of adopting vaccination in this setting.
KW - vaccination
KW - HPV
KW - conization
KW - LEEP
U2 - 10.3390/vaccines8040717
DO - 10.3390/vaccines8040717
M3 - Article
VL - 8
JO - Vaccines
JF - Vaccines
SN - 2076-393X
IS - 4
ER -