Vaccines (Dec 2020)
Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison
- Giorgio Bogani,
- Francesco Raspagliesi,
- Francesco Sopracordevole,
- Andrea Ciavattini,
- Alessandro Ghelardi,
- Tommaso Simoncini,
- Marco Petrillo,
- Francesco Plotti,
- Salvatore Lopez,
- Jvan Casarin,
- Maurizio Serati,
- Ciro Pinelli,
- Gaetano Valenti,
- Alice Bergamini,
- Barbara Giannella,
- Andrea Dell’Acqua,
- Ermelinda Monti,
- Paolo Vercellini,
- Giovanni D’ippolito,
- Lorenzo Aguzzoli,
- Vincenzo D Mandato,
- Paola Carunchio,
- Gabriele Carlifante,
- Luca Giannella,
- Cono Scaffa,
- Francesca Falcone,
- Stefano Ferla,
- Chiara Borghi,
- Antonino Ditto,
- Mario Malzoni,
- Andrea Giannini,
- Maria Giovanna Salerno,
- Viola Liberale,
- Biagio Contino,
- Cristina Donfrancesco,
- Michele Desiato,
- Anna Myriam Perrone,
- Giulia Dondi,
- Pierandrea De Iaco,
- Umberto Leone Roberti Maggiore,
- Mauro Signorelli,
- Valentina Chiappa,
- Simone Ferrero,
- Giuseppe Sarpietro,
- Maria G Matarazzo,
- Antonio Cianci,
- Sara Bocio,
- Simona Ruisi,
- Rocco Guerrisi,
- Claudia Brusadelli,
- Lavinia Mosca,
- Raffaele Tinelli,
- Rosa De Vincenzo,
- Gian Franco Zannoni,
- Gabriella Ferrandina,
- Salvatore Dessole,
- Roberto Angioli,
- Stefano Greggi,
- Arsenio Spinillo,
- Fabio Ghezzi,
- Nicola Colacurci,
- Margherita Fischetti,
- Annunziata Carlea,
- Fulvio Zullo,
- Ludovico Muzii,
- Giovanni Scambia,
- Pierluigi Benedetti Panici,
- Violante Di Donato
Affiliations
- Giorgio Bogani
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy
- Francesco Raspagliesi
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy
- Francesco Sopracordevole
- Gynecological Oncology Unit, Centro di Riferimento Oncologico—National Cancer Institute, Via F. Gallini 2, 33081 Aviano, Italy
- Andrea Ciavattini
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60126 Ancona, Italy
- Alessandro Ghelardi
- Azienda Usl Toscana Nord-Ovest, UOC Ostetricia e Ginecologia, Ospedale Apuane, 56121 Massa, Italy
- Tommaso Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, 56122 Pisa, Italy
- Marco Petrillo
- Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
- Francesco Plotti
- Gynecologic Oncology Unit, Campus Bio-Medico University of Rome, 00128 Rome, Italy
- Salvatore Lopez
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy
- Jvan Casarin
- Department of Obstetrics and Gynecology, ‘Filippo Del Ponte’ Hospital, University of Insubria, 21100 Varese, Italy
- Maurizio Serati
- Department of Obstetrics and Gynecology, ‘Filippo Del Ponte’ Hospital, University of Insubria, 21100 Varese, Italy
- Ciro Pinelli
- Ospedale di Circolo Fondazione Macchi, 21100 Varese, Italy
- Gaetano Valenti
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60126 Ancona, Italy
- Alice Bergamini
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, 20100 Milano, Italy
- Barbara Giannella
- IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Andrea Dell’Acqua
- Gynaecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milan, Italy
- Ermelinda Monti
- Gynaecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milan, Italy
- Paolo Vercellini
- Gynaecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milan, Italy
- Giovanni D’ippolito
- Division of Obstetrics and Gynecology, Cesare Magati Hospital, Scandiano, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42019 Scandiano, Italy
- Lorenzo Aguzzoli
- Division of Obstetrics and Gynecology, Cesare Magati Hospital, Scandiano, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42019 Scandiano, Italy
- Vincenzo D Mandato
- Division of Obstetrics and Gynecology, Cesare Magati Hospital, Scandiano, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42019 Scandiano, Italy
- Paola Carunchio
- Division of Obstetrics and Gynecology, Cesare Magati Hospital, Scandiano, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42019 Scandiano, Italy
- Gabriele Carlifante
- Division of Obstetrics and Gynecology, Cesare Magati Hospital, Scandiano, Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, 42019 Scandiano, Italy
- Luca Giannella
- Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60126 Ancona, Italy
- Cono Scaffa
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy
- Francesca Falcone
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy
- Stefano Ferla
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy
- Chiara Borghi
- Department of Obstetrics and Gynecology, S. Anna University Hospital, 44121 Ferrara, Italy
- Antonino Ditto
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy
- Mario Malzoni
- Endoscopica Malzoni, Center for Advanced Endoscopic Gynecological Surgery, 83100 Avellino, Italy
- Andrea Giannini
- Department of Woman’s and Child’s Health, Obstetrics and Gynecological Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy
- Maria Giovanna Salerno
- Department of Woman’s and Child’s Health, Obstetrics and Gynecological Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy
- Viola Liberale
- Department of Obstetrics and Gynecology, Ospedale Maria Vittoria, 10144 Torino, Italy
- Biagio Contino
- Department of Obstetrics and Gynecology, Ospedale Maria Vittoria, 10144 Torino, Italy
- Cristina Donfrancesco
- Department of Obstetrics and Gynecology, Azienda ASL Frosinone, Ospedale S Trinità di Sora, 03039 Sora, Italy
- Michele Desiato
- Department of Obstetrics and Gynecology, Azienda ASL Frosinone, Ospedale S Trinità di Sora, 03039 Sora, Italy
- Anna Myriam Perrone
- Division of Oncologic Gynecology, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Giulia Dondi
- Division of Oncologic Gynecology, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Pierandrea De Iaco
- Division of Oncologic Gynecology, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Umberto Leone Roberti Maggiore
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy
- Mauro Signorelli
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy
- Valentina Chiappa
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy
- Simone Ferrero
- Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Giuseppe Sarpietro
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic University of Catania, Via S. Sofia 78, 95124 Catania, Italy
- Maria G Matarazzo
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic University of Catania, Via S. Sofia 78, 95124 Catania, Italy
- Antonio Cianci
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic University of Catania, Via S. Sofia 78, 95124 Catania, Italy
- Sara Bocio
- Department of Gynecology, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy
- Simona Ruisi
- Department of Gynecology, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy
- Rocco Guerrisi
- Ospedale di Circolo Fondazione Macchi, 21100 Varese, Italy
- Claudia Brusadelli
- Ospedale di Circolo Fondazione Macchi, 21100 Varese, Italy
- Lavinia Mosca
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Raffaele Tinelli
- Department of Obstetrics and Gynecology, "Valle d’Itria" Hospital, Martina Franca, Via San Francesco da Paola, 74015 Taranto, Italy
- Rosa De Vincenzo
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
- Gian Franco Zannoni
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
- Gabriella Ferrandina
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
- Salvatore Dessole
- Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
- Roberto Angioli
- Gynecologic Oncology Unit, Campus Bio-Medico University of Rome, 00128 Rome, Italy
- Stefano Greggi
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy
- Arsenio Spinillo
- IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Fabio Ghezzi
- Department of Obstetrics and Gynecology, ‘Filippo Del Ponte’ Hospital, University of Insubria, 21100 Varese, Italy
- Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Margherita Fischetti
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00185 Rome, Italy
- Annunziata Carlea
- Department of Neuroscience, Reproductive Science and Dentistry, School of Medicine, University of Naples Federico II, 80126 Naples, Italy
- Fulvio Zullo
- Department of Neuroscience, Reproductive Science and Dentistry, School of Medicine, University of Naples Federico II, 80126 Naples, Italy
- Ludovico Muzii
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00185 Rome, Italy
- Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
- Pierluigi Benedetti Panici
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00185 Rome, Italy
- Violante Di Donato
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00185 Rome, Italy
- DOI
- https://doi.org/10.3390/vaccines8040717
- Journal volume & issue
-
Vol. 8,
no. 4
p. 717
Abstract
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 1.7% (n = 2) and 5.7% (n = 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.
Keywords
