TY - JOUR
T1 - High-risk HPV-positive and -negative high-grade cervical dysplasia
T2 - Analysis of 5-year outcomes
AU - Bogani, Giorgio
AU - Sopracordevole, Francesco
AU - Di Donato, Violante
AU - Ciavattini, Andrea
AU - Ghelardi, Alessandro
AU - Lopez, Salvatore
AU - Simoncini, Tommaso
AU - Plotti, Francesco
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 - Fischetti, Margherita
AU - D'ippolito, Giovanni
AU - Aguzzoli, Lorenzo
AU - Mandato, Vincenzo D.
AU - Carunchio, Paola
AU - Carlinfante, Gabriele
AU - Giannella, Luca
AU - Scaffa, Cono
AU - Falcone, Francesca
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 - Chiappa, Valentina
AU - Ferrero, Simone
AU - Sarpietro, Giuseppe
AU - Matarazzo, Maria G.
AU - Cianci, Antonio
AU - Bosio, Sara
AU - Ruisi, Simona
AU - Guerrisi, Rocco
AU - Brusadelli, Claudia
AU - Mosca, Lavinia
AU - Lagana’, Antonio Simone
AU - Tinelli, Raffaele
AU - Signorelli, Mauro
AU - De Vincenzo, Rosa
AU - Zannoni, Gian Franco
AU - Ferrandina, Gabriella
AU - Lovati, Sara
AU - Petrillo, Marco
AU - Dessole, Salvatore
AU - Carlea, Annunziata
AU - Zullo, Fulvio
AU - Angioli, Roberto
AU - Greggi, Stefano
AU - Spinillo, Arsenio
AU - Ghezzi, Fabio
AU - Colacurci, Nicola
AU - Muzii, Ludovico
AU - Benedetti Panici, Pierluigi
AU - Scambia, Giovanni
AU - Raspagliesi, Francesco
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - CIN
KW - Conization
KW - HPV
KW - Negative
KW - Positive
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U2 - 10.1016/j.ygyno.2021.01.020
DO - 10.1016/j.ygyno.2021.01.020
M3 - Article
AN - SCOPUS:85099848538
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
ER -