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.
Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization / Giannini, A.; Di Donato, V.; Sopracordevole, F.; Ciavattini, A.; Ghelardi, A.; Vizza, E.; D'Oria, O.; Simoncini, T.; Plotti, F.; Casarin, J.; Golia D'Auge, T.; Cuccu, I.; Serati, M.; Pinelli, C.; Bergamini, A.; Gardella, B.; Dell'Acqua, A.; Monti, E.; Vercellini, P.; D'Ippolito, G.; Aguzzoli, L.; Dario Mandato, V.; Giannella, L.; Scaffa, C.; Ditto, A.; Falcone, F.; Borghi, C.; Malzoni, M.; Di Giovanni, A.; Salerno, M. G.; Liberale, V.; Contino, B.; Donfrancesco, C.; Desiato, M.; Perrone, A. M.; De Iaco, P.; Ferrero, S.; Sarpietro, G.; Matarazzo, M. G.; Cianci, A.; Cianci, S.; Bosio, S.; Ruisi, S.; Mosca, L.; Tinelli, R.; De Vincenzo, R.; Zannoni, G. F.; Ferrandina, G.; Petrillo, M.; Capobianco, G.; Carlea, A.; Zullo, F.; Muschiato, B.; Palomba, S.; Greggi, S.; Spinillo, A.; Ghezzi, F.; Colacurci, N.; Angioli, R.; Benedetti Panici, P.; Muzii, L.; Scambia, G.; Raspagliesi, F.; Bogani, G.. - In: VACCINES. - ISSN 2076-393X. - 11:3(2023), p. 698. [10.3390/vaccines11030698]