Human papillomavirus (HPV) persistence and HPV 31 predict the risk of recurrence in high-grade vaginal intraepithelial neoplasia

Giorgio Bogani, Fabio Martinelli, Antonino Ditto, Francesca Taverna, Claudia Lombardo, Mauro Signorelli, Valentina Chiappa, Umberto Leone Roberti Maggiore, Caterina Fontanella, Ilaria Sabatucci, Chiara Borghi, Dario Recalcati, Alice Indini, Domenica Lorusso, Francesco Raspagliesi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective High-grade vaginal intraepithelial neoplasia (vaginal HSIL) represents an uncommon entity. Here, we sought to identify predictors for recurrence and risk factor for developing genital cancers after primary treatment for vaginal HSIL. Methods Data of consecutive 5104 women who had human papillomavirus (HPV) DNA test were searched for identify women with histological confirmed vaginal HSIL. Disease-free interval and the risk of developing HPV-related gynecological cancers were assessed using Kaplan-Meier and Cox proportional hazard models. Results Overall, 77 patients were included. After a mean (SD) follow-up of 69.3 (33.0) months, 11 (14%) and 4 (5%) patients experienced vaginal HSIL recurrence and the occurrence of HPV-related gynecological cancers, respectively. Via multivariate analysis factors predicting for vaginal HSIL recurrence were infection from HPV31 at diagnosis (HR: 5.0 (95%CI:1.17, 21.3); p = 0.03) and persistence of HPV infection after treatment (HR: 7.0 (95%CI:1.54, 31.6); p = 0.01). Additionally, patients who had LASER ablation experienced a trend toward a lower risk of recurrence in comparison to medical treatment (HR: 0.20 (95%CI:0.03, 1.09); p = 0.06). Considering the occurrence of HPV-related gynecological cancers, we observed that no factors independently correlated with this risk; while, a trend towards higher risk was observed for women with HIV infection (HR:16.4 (95%CI:0.90, 300.1); p = 0.06) and persistence of HPV infection (HR: 13.3 (95%CI:0.76, 230.2); p = 0.07). Conclusions Patients affected by vaginal HSIL experienced a relatively high risk of recurrence. Persistence of HPV after treatment and pretreatment HPV-31 infection predicts for high-grade vaginal intraepithelial neoplasia recurrence. Further investigations are warranted in order to corroborate our data.

Original languageEnglish
Pages (from-to)157-165
Number of pages9
JournalEuropean Journal of Obstetrics, Gynecology and Reproductive Biology
Volume210
DOIs
Publication statusPublished - Mar 1 2017

Fingerprint

Human papillomavirus 31
Recurrence
Papillomavirus Infections
Neoplasms
Human Papillomavirus DNA Tests
Therapeutics
Proportional Hazards Models
HIV Infections
Multivariate Analysis
Infection

Keywords

  • Genital cancer
  • HPV
  • Neoplasia
  • Vaginal intraepithelial neoplasia
  • VAIN

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Human papillomavirus (HPV) persistence and HPV 31 predict the risk of recurrence in high-grade vaginal intraepithelial neoplasia. / Bogani, Giorgio; Martinelli, Fabio; Ditto, Antonino; Taverna, Francesca; Lombardo, Claudia; Signorelli, Mauro; Chiappa, Valentina; Leone Roberti Maggiore, Umberto; Fontanella, Caterina; Sabatucci, Ilaria; Borghi, Chiara; Recalcati, Dario; Indini, Alice; Lorusso, Domenica; Raspagliesi, Francesco.

In: European Journal of Obstetrics, Gynecology and Reproductive Biology, Vol. 210, 01.03.2017, p. 157-165.

Research output: Contribution to journalArticle

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abstract = "Objective High-grade vaginal intraepithelial neoplasia (vaginal HSIL) represents an uncommon entity. Here, we sought to identify predictors for recurrence and risk factor for developing genital cancers after primary treatment for vaginal HSIL. Methods Data of consecutive 5104 women who had human papillomavirus (HPV) DNA test were searched for identify women with histological confirmed vaginal HSIL. Disease-free interval and the risk of developing HPV-related gynecological cancers were assessed using Kaplan-Meier and Cox proportional hazard models. Results Overall, 77 patients were included. After a mean (SD) follow-up of 69.3 (33.0) months, 11 (14{\%}) and 4 (5{\%}) patients experienced vaginal HSIL recurrence and the occurrence of HPV-related gynecological cancers, respectively. Via multivariate analysis factors predicting for vaginal HSIL recurrence were infection from HPV31 at diagnosis (HR: 5.0 (95{\%}CI:1.17, 21.3); p = 0.03) and persistence of HPV infection after treatment (HR: 7.0 (95{\%}CI:1.54, 31.6); p = 0.01). Additionally, patients who had LASER ablation experienced a trend toward a lower risk of recurrence in comparison to medical treatment (HR: 0.20 (95{\%}CI:0.03, 1.09); p = 0.06). Considering the occurrence of HPV-related gynecological cancers, we observed that no factors independently correlated with this risk; while, a trend towards higher risk was observed for women with HIV infection (HR:16.4 (95{\%}CI:0.90, 300.1); p = 0.06) and persistence of HPV infection (HR: 13.3 (95{\%}CI:0.76, 230.2); p = 0.07). Conclusions Patients affected by vaginal HSIL experienced a relatively high risk of recurrence. Persistence of HPV after treatment and pretreatment HPV-31 infection predicts for high-grade vaginal intraepithelial neoplasia recurrence. Further investigations are warranted in order to corroborate our data.",
keywords = "Genital cancer, HPV, Neoplasia, Vaginal intraepithelial neoplasia, VAIN",
author = "Giorgio Bogani and Fabio Martinelli and Antonino Ditto and Francesca Taverna and Claudia Lombardo and Mauro Signorelli and Valentina Chiappa and {Leone Roberti Maggiore}, Umberto and Caterina Fontanella and Ilaria Sabatucci and Chiara Borghi and Dario Recalcati and Alice Indini and Domenica Lorusso and Francesco Raspagliesi",
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T1 - Human papillomavirus (HPV) persistence and HPV 31 predict the risk of recurrence in high-grade vaginal intraepithelial neoplasia

AU - Bogani, Giorgio

AU - Martinelli, Fabio

AU - Ditto, Antonino

AU - Taverna, Francesca

AU - Lombardo, Claudia

AU - Signorelli, Mauro

AU - Chiappa, Valentina

AU - Leone Roberti Maggiore, Umberto

AU - Fontanella, Caterina

AU - Sabatucci, Ilaria

AU - Borghi, Chiara

AU - Recalcati, Dario

AU - Indini, Alice

AU - Lorusso, Domenica

AU - Raspagliesi, Francesco

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objective High-grade vaginal intraepithelial neoplasia (vaginal HSIL) represents an uncommon entity. Here, we sought to identify predictors for recurrence and risk factor for developing genital cancers after primary treatment for vaginal HSIL. Methods Data of consecutive 5104 women who had human papillomavirus (HPV) DNA test were searched for identify women with histological confirmed vaginal HSIL. Disease-free interval and the risk of developing HPV-related gynecological cancers were assessed using Kaplan-Meier and Cox proportional hazard models. Results Overall, 77 patients were included. After a mean (SD) follow-up of 69.3 (33.0) months, 11 (14%) and 4 (5%) patients experienced vaginal HSIL recurrence and the occurrence of HPV-related gynecological cancers, respectively. Via multivariate analysis factors predicting for vaginal HSIL recurrence were infection from HPV31 at diagnosis (HR: 5.0 (95%CI:1.17, 21.3); p = 0.03) and persistence of HPV infection after treatment (HR: 7.0 (95%CI:1.54, 31.6); p = 0.01). Additionally, patients who had LASER ablation experienced a trend toward a lower risk of recurrence in comparison to medical treatment (HR: 0.20 (95%CI:0.03, 1.09); p = 0.06). Considering the occurrence of HPV-related gynecological cancers, we observed that no factors independently correlated with this risk; while, a trend towards higher risk was observed for women with HIV infection (HR:16.4 (95%CI:0.90, 300.1); p = 0.06) and persistence of HPV infection (HR: 13.3 (95%CI:0.76, 230.2); p = 0.07). Conclusions Patients affected by vaginal HSIL experienced a relatively high risk of recurrence. Persistence of HPV after treatment and pretreatment HPV-31 infection predicts for high-grade vaginal intraepithelial neoplasia recurrence. Further investigations are warranted in order to corroborate our data.

AB - Objective High-grade vaginal intraepithelial neoplasia (vaginal HSIL) represents an uncommon entity. Here, we sought to identify predictors for recurrence and risk factor for developing genital cancers after primary treatment for vaginal HSIL. Methods Data of consecutive 5104 women who had human papillomavirus (HPV) DNA test were searched for identify women with histological confirmed vaginal HSIL. Disease-free interval and the risk of developing HPV-related gynecological cancers were assessed using Kaplan-Meier and Cox proportional hazard models. Results Overall, 77 patients were included. After a mean (SD) follow-up of 69.3 (33.0) months, 11 (14%) and 4 (5%) patients experienced vaginal HSIL recurrence and the occurrence of HPV-related gynecological cancers, respectively. Via multivariate analysis factors predicting for vaginal HSIL recurrence were infection from HPV31 at diagnosis (HR: 5.0 (95%CI:1.17, 21.3); p = 0.03) and persistence of HPV infection after treatment (HR: 7.0 (95%CI:1.54, 31.6); p = 0.01). Additionally, patients who had LASER ablation experienced a trend toward a lower risk of recurrence in comparison to medical treatment (HR: 0.20 (95%CI:0.03, 1.09); p = 0.06). Considering the occurrence of HPV-related gynecological cancers, we observed that no factors independently correlated with this risk; while, a trend towards higher risk was observed for women with HIV infection (HR:16.4 (95%CI:0.90, 300.1); p = 0.06) and persistence of HPV infection (HR: 13.3 (95%CI:0.76, 230.2); p = 0.07). Conclusions Patients affected by vaginal HSIL experienced a relatively high risk of recurrence. Persistence of HPV after treatment and pretreatment HPV-31 infection predicts for high-grade vaginal intraepithelial neoplasia recurrence. Further investigations are warranted in order to corroborate our data.

KW - Genital cancer

KW - HPV

KW - Neoplasia

KW - Vaginal intraepithelial neoplasia

KW - VAIN

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