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Development of a Nomogram Predicting the Risk of Persistence/Recurrence of Cervical Dysplasia

Authors :
Giorgio Bogani
Luca Lalli
Francesco Sopracordevole
Andrea Ciavattini
Alessandro Ghelardi
Tommaso Simoncini
Francesco Plotti
Jvan Casarin
Maurizio Serati
Ciro Pinelli
Alice Bergamini
Barbara Gardella
Andrea Dell’Acqua
Ermelinda Monti
Paolo Vercellini
Innocenza Palaia
Giorgia Perniola
Margherita Fischetti
Giusi Santangelo
Alice Fracassi
Giovanni D’Ippolito
Lorenzo Aguzzoli
Vincenzo Dario Mandato
Luca Giannella
Cono Scaffa
Francesca Falcone
Chiara Borghi
Mario Malzoni
Andrea Giannini
Maria Giovanna Salerno
Viola Liberale
Biagio Contino
Cristina Donfrancesco
Michele Desiato
Anna Myriam Perrone
Giulia Dondi
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
Salvatore Dessiole
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
Violante Di Donato
Source :
Vaccines, Vol 10, Iss 4, p 579 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Background: Cervical dysplasia persistence/recurrence has a great impact on women’s health and quality of life. In this study, we investigated whether a prognostic nomogram may improve risk assessment after primary conization. Methods: This is a retrospective multi-institutional study based on charts of consecutive patients undergoing conization between 1 January 2010 and 31 December 2014. A nomogram assessing the importance of different variables was built. A cohort of patients treated between 1 January 2015 and 30 June 2016 was used to validate the nomogram. Results: A total of 2966 patients undergoing primary conization were analyzed. The median (range) patient age was 40 (18–89) years. At 5-year of follow-up, 6% of patients (175/2966) had developed a persistent/recurrent cervical dysplasia. Median (range) recurrence-free survival was 18 (5–52) months. Diagnosis of CIN3, presence of HR-HPV types, positive endocervical margins, HPV persistence, and the omission of HPV vaccination after conization increased significantly and independently of the risk of developing cervical dysplasia persistence/recurrence. A nomogram weighting the impact of all variables was built with a C-Index of 0.809. A dataset of 549 patients was used to validate the nomogram, with a C-index of 0.809. Conclusions: The present nomogram represents a useful tool for counseling women about their risk of persistence/recurrence after primary conization. HPV vaccination after conization is associated with a reduced risk of CIN2+.

Details

Language :
English
ISSN :
10040579 and 2076393X
Volume :
10
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Vaccines
Publication Type :
Academic Journal
Accession number :
edsdoj.6135fa19f6548dca71a184e4a545319
Document Type :
article
Full Text :
https://doi.org/10.3390/vaccines10040579