Vaccines (Mar 2023)
Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization
- Andrea Giannini,
- Violante Di Donato,
- Francesco Sopracordevole,
- Andrea Ciavattini,
- Alessandro Ghelardi,
- Enrico Vizza,
- Ottavia D’Oria,
- Tommaso Simoncini,
- Francesco Plotti,
- Jvan Casarin,
- Tullio Golia D’Augè,
- Ilaria Cuccu,
- Maurizio Serati,
- Ciro Pinelli,
- Alice Bergamini,
- Barbara Gardella,
- Andrea Dell’Acqua,
- Ermelinda Monti,
- Paolo Vercellini,
- Giovanni D’Ippolito,
- Lorenzo Aguzzoli,
- Vincenzo Dario Mandato,
- Luca Giannella,
- Cono Scaffa,
- Antonino Ditto,
- Francesca Falcone,
- Chiara Borghi,
- Mario Malzoni,
- Alessandra Di Giovanni,
- Maria Giovanna Salerno,
- Viola Liberale,
- Biagio Contino,
- Cristina Donfrancesco,
- Michele Desiato,
- Anna Myriam Perrone,
- Pierandrea De Iaco,
- Simone Ferrero,
- Giuseppe Sarpietro,
- Maria G. Matarazzo,
- Antonio Cianci,
- Stefano Cianci,
- Sara Bosio,
- Simona Ruisi,
- Lavinia Mosca,
- Raffaele Tinelli,
- Rosa De Vincenzo,
- Gian Franco Zannoni,
- Gabriella Ferrandina,
- Marco Petrillo,
- Giampiero Capobianco,
- Annunziata Carlea,
- Fulvio Zullo,
- Barbara Muschiato,
- Stefano Palomba,
- Stefano Greggi,
- Arsenio Spinillo,
- Fabio Ghezzi,
- Nicola Colacurci,
- Roberto Angioli,
- Pierluigi Benedetti Panici,
- Ludovico Muzii,
- Giovanni Scambia,
- Francesco Raspagliesi,
- Giorgio Bogani
Affiliations
- Andrea Giannini
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
- Violante Di Donato
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
- Francesco Sopracordevole
- Gynecological Oncology Unit, Centro di Riferimento Oncologico-National Cancer Institute, 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, 54100 Massa, Italy
- Enrico Vizza
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
- Ottavia D’Oria
- Department of Woman’s and Child’s Health, Obstetrics and Gynecological Unit, San Camillo-Forlanini Hospital, 00152 Rome, Italy
- Tommaso Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Francesco Plotti
- Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, 00128 Rome, Italy
- Jvan Casarin
- Department of Obstetrics and Gynecology, ‘Filippo Del Ponte’ Hospital, University of Insubria, 21100 Varese, Italy
- Tullio Golia D’Augè
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
- Ilaria Cuccu
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00161 Rome, 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
- Alice Bergamini
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, 20100 Milano, Italy
- Barbara Gardella
- 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, 20122 Milan, Italy
- Ermelinda Monti
- Gynaecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Paolo Vercellini
- Gynaecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Giovanni D’Ippolito
- Division of Obstetrics and Gynecology, Cesare Magati Hospital, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42019 Scandiano, Italy
- Lorenzo Aguzzoli
- Division of Obstetrics and Gynecology, Cesare Magati Hospital, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42019 Scandiano, Italy
- Vincenzo Dario Mandato
- Division of Obstetrics and Gynecology, Cesare Magati Hospital, 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
- Antonino Ditto
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy
- Francesca Falcone
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy
- Chiara Borghi
- Department of Obstetrics and Gynecology, S. Anna University Hospital, 44121 Ferrara, Italy
- Mario Malzoni
- Endoscopica Malzoni, Center for Advanced Endoscopic Gynecological Surgery, 83100 Avellino, Italy
- Alessandra Di Giovanni
- Endoscopica Malzoni, Center for Advanced Endoscopic Gynecological Surgery, 83100 Avellino, 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
- Gynecologic Oncology Unit, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy
- Pierandrea De Iaco
- Gynecologic Oncology Unit, Sant’Orsola-Malpighi Hospital, 40138 Bologna, 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
- Stefano Cianci
- Department of Gynecologic Oncology, Università degli Studi di Messina, Policlinico G. Martino, 98122 Messina, Italy
- Sara Bosio
- San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy
- Simona Ruisi
- San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, 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 Rome, 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 Rome, 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 Rome, Italy
- Marco Petrillo
- Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
- Giampiero Capobianco
- Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
- Annunziata Carlea
- Department of Neuroscience, Reproductive Science and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
- Fulvio Zullo
- Department of Neuroscience, Reproductive Science and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
- Barbara Muschiato
- Studio Medico Muschiato, Loano & Finale Ligure, 17025 Loano, Italy
- Stefano Palomba
- Unit of Obstetrics and Gynecology, GOM of Reggio Calabria & University ‘Magna Graecia’ of Catanzaro, 88100 Catanzaro, 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
- Roberto Angioli
- Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, 00128 Rome, Italy
- Pierluigi Benedetti Panici
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
- Ludovico Muzii
- Department of Gynecological, Obstetrical and Urological Sciences, “Sapienza” University of Rome, 00161 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 Rome, Italy
- Francesco Raspagliesi
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy
- Giorgio Bogani
- Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy
- DOI
- https://doi.org/10.3390/vaccines11030698
- Journal volume & issue
-
Vol. 11,
no. 3
p. 698
Abstract
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 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.
Keywords
