학술논문
Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization
Document Type
article
Author
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
Source
Vaccines, Vol 11, Iss 3, p 698 (2023)
Subject
Language
English
ISSN
2076-393X
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 < 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.