HPV Vaccination after Primary Treatment of HPV-Related Disease across Different Organ Sites: A Multidisciplinary Comprehensive Review and Meta-Analysis
Violante Di Donato,
Giuseppe Caruso,
Giorgio Bogani,
Eugenio Nelson Cavallari,
Gaspare Palaia,
Giorgia Perniola,
Massimo Ralli,
Sara Sorrenti,
Umberto Romeo,
Angelina Pernazza,
Alessandra Pierangeli,
Ilaria Clementi,
Andrea Mingoli,
Andrea Cassoni,
Federica Tanzi,
Ilaria Cuccu,
Nadia Recine,
Pasquale Mancino,
Marco de Vincentiis,
Valentino Valentini,
Gabriella d’Ettorre,
Carlo Della Rocca,
Claudio Maria Mastroianni,
Guido Antonelli,
Antonella Polimeni,
Ludovico Muzii,
Innocenza Palaia
Affiliations
Violante Di Donato
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Giuseppe Caruso
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Giorgio Bogani
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Eugenio Nelson Cavallari
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Gaspare Palaia
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Giorgia Perniola
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Massimo Ralli
Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Sara Sorrenti
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Umberto Romeo
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Angelina Pernazza
Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Alessandra Pierangeli
Department of Molecular Medicine, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Ilaria Clementi
Department of Emergency, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Andrea Mingoli
Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Andrea Cassoni
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Federica Tanzi
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Ilaria Cuccu
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Nadia Recine
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Pasquale Mancino
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Marco de Vincentiis
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Valentino Valentini
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Gabriella d’Ettorre
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Carlo Della Rocca
Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Claudio Maria Mastroianni
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Guido Antonelli
Department of Molecular Medicine, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Antonella Polimeni
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Ludovico Muzii
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Innocenza Palaia
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Objective: To assess evidence on the efficacy of adjuvant human papillomavirus (HPV) vaccination in patients treated for HPV-related disease across different susceptible organ sites. Methods: A systematic review was conducted to identify studies addressing the efficacy of adjuvant HPV vaccination on reducing the risk of recurrence of HPV-related preinvasive diseases. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI). Results: Sixteen studies were identified for the final analysis. Overall, 21,472 patients with cervical dysplasia were included: 4132 (19.2%) received the peri-operative HPV vaccine, while 17,340 (80.8%) underwent surgical treatment alone. The recurrences of CIN 1+ (OR 0.45, 95% CI 0.27 to 0.73; p = 0.001), CIN 2+ (OR 0.33, 95% CI 0.20 to 0.52; p p = 0.0009) were lower in the vaccinated than in unvaccinated group. Similarly, adjuvant vaccination reduced the risk of developing anal intraepithelial neoplasia (p = 0.005) and recurrent respiratory papillomatosis (p = 0.004). No differences in anogenital warts and vulvar intraepithelial neoplasia recurrence rate were observed comparing vaccinated and unvaccinated individuals. Conclusions: Adjuvant HPV vaccination is associated with a reduced risk of CIN recurrence, although there are limited data regarding its role in other HPV-related diseases. Further research is warranted to shed more light on the role of HPV vaccination as adjuvant therapy after primary treatment.
