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Development of a Nomogram Predicting the Risk of Persistence/Recurrence of Cervical Dysplasia
- 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+.
- Subjects :
- HPV
conization
cervical dysplasia
LEEP
recurrence
Medicine
Subjects
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