Objective: To evaluate the outcomes of high-risk (HR) HPV-positive and -negative women affected by high-grade cervical dysplasia. Methods: This is a retrospective multi-institutional study. Medical records of consecutive patients with high-grade cervical dysplasia undergoing conization between 2010 and 2014 were retrieved. All patients included had at least 5 years of follow-up. A propensity-score matching was adopted in order to reduce the presence of confounding factors between groups. Kaplan-Meir and Cox hazard models were used to estimate 5-year outcomes. Results: Overall, data of 2966 women, affected by high-grade cervical dysplasia were reviewed. The study population included 1478 (85%) and 260 (15%) women affected by HR-HPV-positive and HR-HPV-negative high-grade cervical dysplasia. The prevalence of CIN2 and CIN3 among the HR-HPV-positive and -negative cohort was similar (p = 0.315). Patients with HR-HPV-positive high-grade cervical dysplasia were at higher risk of 5-year recurrence (after primary conization) that HR-HPV-negative patients (p < 0.001, log-rank test). Via multivariate analysis, HR-HPV-negative women were at low risk of recurrence (HR: 1.69 (95%CI: 1.05, 4.80); p = 0.018, Cox Hazard model). A propensity-score matched comparison was carried out in order to reduce biases that are related to the retrospective study design. In comparison to HR-HPV-negative patients, thosewith HR-HPV-positive CIN3 was associate with a 8-fold increase in the risk of recurrence (p < 0.001, log-rank test). Conclusions: HR-HPV-negative high-grade cervical dysplasia is not uncommon, accounting for 15% of our study population. Those patients experience more favorable outcomes than patients with documented HR-HPV infection(s). Further prospective studies are needed to corroborate our data.
High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes / Bogani, G.; Sopracordevole, F.; Di Donato, V.; Ciavattini, A.; Ghelardi, A.; Lopez, S.; Simoncini, T.; Plotti, F.; Casarin, J.; Serati, M.; Pinelli, C.; Valenti, G.; Bergamini, A.; Gardella, B.; Dell'Acqua, A.; Monti, E.; Vercellini, P.; Fischetti, M.; D'Ippolito, G.; Aguzzoli, L.; Mandato, V. D.; Carunchio, P.; Carlinfante, G.; Giannella, L.; Scaffa, C.; Falcone, F.; Borghi, C.; Ditto, A.; Malzoni, M.; Giannini, A.; Salerno, M. G.; Liberale, V.; Contino, B.; Donfrancesco, C.; Desiato, M.; Perrone, A. M.; Dondi, G.; De Iaco, P.; Chiappa, V.; Ferrero, S.; Sarpietro, G.; Matarazzo, M. G.; Cianci, A.; Bosio, S.; Ruisi, S.; Guerrisi, R.; Brusadelli, C.; Mosca, L.; Lagana', A. S.; Tinelli, R.; Signorelli, M.; De Vincenzo, R.; Zannoni, G. F.; Ferrandina, G.; Lovati, S.; Petrillo, M.; Dessole, S.; Carlea, A.; Zullo, F.; Angioli, R.; Greggi, S.; Spinillo, A.; Ghezzi, F.; Colacurci, N.; Muzii, L.; Benedetti Panici, P.; Scambia, G.; Raspagliesi, F.. - In: GYNECOLOGIC ONCOLOGY. - ISSN 0090-8258. - 161:1(2021), pp. 173-178. [10.1016/j.ygyno.2021.01.020]