Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization.

Autor: Giannini A; Department of Gynecological, Obstetrical and Urological Sciences, 'Sapienza' University of Rome, 00161 Rome, Italy., Di Donato V; Department of Gynecological, Obstetrical and Urological Sciences, 'Sapienza' University of Rome, 00161 Rome, Italy., Sopracordevole F; Gynecological Oncology Unit, Centro di Riferimento Oncologico-National Cancer Institute, 33081 Aviano, Italy., Ciavattini A; Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60126 Ancona, Italy., Ghelardi A; Azienda Usl Toscana Nord-Ovest, UOC Ostetricia e Ginecologia, Ospedale Apuane, 54100 Massa, Italy., Vizza E; Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS 'Regina Elena' National Cancer Institute, 00144 Rome, Italy., D'Oria O; Department of Woman's and Child's Health, Obstetrics and Gynecological Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy., Simoncini T; Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy., Plotti F; Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, 00128 Rome, Italy., Casarin J; Department of Obstetrics and Gynecology, 'Filippo Del Ponte' Hospital, University of Insubria, 21100 Varese, Italy., Golia D'Augè T; Department of Gynecological, Obstetrical and Urological Sciences, 'Sapienza' University of Rome, 00161 Rome, Italy., Cuccu I; Department of Gynecological, Obstetrical and Urological Sciences, 'Sapienza' University of Rome, 00161 Rome, Italy., Serati M; Department of Obstetrics and Gynecology, 'Filippo Del Ponte' Hospital, University of Insubria, 21100 Varese, Italy., Pinelli C; Ospedale di Circolo Fondazione Macchi, 21100 Varese, Italy., Bergamini A; Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, 20100 Milano, Italy., Gardella B; IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy., Dell'Acqua A; Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy., Monti E; Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy., Vercellini P; Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy., D'Ippolito G; Division of Obstetrics and Gynecology, Cesare Magati Hospital, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42019 Scandiano, Italy., Aguzzoli L; Division of Obstetrics and Gynecology, Cesare Magati Hospital, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42019 Scandiano, Italy., Mandato VD; Division of Obstetrics and Gynecology, Cesare Magati Hospital, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42019 Scandiano, Italy., Giannella L; Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60126 Ancona, Italy., Scaffa C; Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', 80131 Naples, Italy., Ditto A; Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy., Falcone F; Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', 80131 Naples, Italy., Borghi C; Department of Obstetrics and Gynecology, S. Anna University Hospital, 44121 Ferrara, Italy., Malzoni M; Endoscopica Malzoni, Center for Advanced Endoscopic Gynecological Surgery, 83100 Avellino, Italy., Di Giovanni A; Endoscopica Malzoni, Center for Advanced Endoscopic Gynecological Surgery, 83100 Avellino, Italy., Salerno MG; Department of Woman's and Child's Health, Obstetrics and Gynecological Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy., Liberale V; Department of Obstetrics and Gynecology, Ospedale Maria Vittoria, 10144 Torino, Italy., Contino B; Department of Obstetrics and Gynecology, Ospedale Maria Vittoria, 10144 Torino, Italy., Donfrancesco C; Department of Obstetrics and Gynecology, Azienda ASL Frosinone, Ospedale S Trinità di Sora, 03039 Sora, Italy., Desiato M; Department of Obstetrics and Gynecology, Azienda ASL Frosinone, Ospedale S Trinità di Sora, 03039 Sora, Italy., Perrone AM; Gynecologic Oncology Unit, Sant'Orsola-Malpighi Hospital, 40138 Bologna, Italy., De Iaco P; Gynecologic Oncology Unit, Sant'Orsola-Malpighi Hospital, 40138 Bologna, Italy., Ferrero S; Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, 16132 Genova, Italy., Sarpietro G; Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic University of Catania, Via S. Sofia 78, 95124 Catania, Italy., Matarazzo MG; Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic University of Catania, Via S. Sofia 78, 95124 Catania, Italy., Cianci A; Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic University of Catania, Via S. Sofia 78, 95124 Catania, Italy., Cianci S; Department of Gynecologic Oncology, Università degli Studi di Messina, Policlinico G. Martino, 98122 Messina, Italy., Bosio S; San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy., Ruisi S; San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy., Mosca L; Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Tinelli R; Department of Obstetrics and Gynecology, 'Valle d'Itria' Hospital, Martina Franca, Via San Francesco da Paola, 74015 Taranto, Italy., De Vincenzo R; UOC Ginecologia Oncologica, Dipartimento per la Salute Della Donna e del Bambino e Della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy., Zannoni GF; UOC Ginecologia Oncologica, Dipartimento per la Salute Della Donna e del Bambino e Della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy., Ferrandina G; UOC Ginecologia Oncologica, Dipartimento per la Salute Della Donna e del Bambino e Della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy., Petrillo M; Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy., Capobianco G; Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy., Carlea A; Department of Neuroscience, Reproductive Science and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy., Zullo F; Department of Neuroscience, Reproductive Science and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy., Muschiato B; Studio Medico Muschiato, Loano & Finale Ligure, 17025 Loano, Italy., Palomba S; Unit of Obstetrics and Gynecology, GOM of Reggio Calabria & University 'Magna Graecia' of Catanzaro, 88100 Catanzaro, Italy., Greggi S; Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', 80131 Naples, Italy., Spinillo A; IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy., Ghezzi F; Department of Obstetrics and Gynecology, 'Filippo Del Ponte' Hospital, University of Insubria, 21100 Varese, Italy.; Ospedale di Circolo Fondazione Macchi, 21100 Varese, Italy., Colacurci N; Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Angioli R; Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, 00128 Rome, Italy., Benedetti Panici P; Department of Gynecological, Obstetrical and Urological Sciences, 'Sapienza' University of Rome, 00161 Rome, Italy., Muzii L; Department of Gynecological, Obstetrical and Urological Sciences, 'Sapienza' University of Rome, 00161 Rome, Italy., Scambia G; UOC Ginecologia Oncologica, Dipartimento per la Salute Della Donna e del Bambino e Della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy., Raspagliesi F; Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy., Bogani G; Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy.
Jazyk: angličtina
Zdroj: Vaccines [Vaccines (Basel)] 2023 Mar 18; Vol. 11 (3). Date of Electronic Publication: 2023 Mar 18.
DOI: 10.3390/vaccines11030698
Abstrakt: 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.
Databáze: MEDLINE