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 multiinstitutional 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+.

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

Bogani G.;Casarin J.;Serati M.;Pinelli C.;Santangelo G.;Giannella L.;Ghezzi F.;
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 multiinstitutional 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+.
cervical dysplasia; conization; HPV; LEEP; recurrence
Bogani, G.; Lalli, L.; Sopracordevole, F.; Ciavattini, A.; Ghelardi, A.; Simoncini, T.; Plotti, F.; Casarin, J.; Serati, M.; Pinelli, C.; Bergamini, A.; Gardella, B.; Dell'Acqua, A.; Monti, E.; Vercellini, P.; Palaia, I.; Perniola, G.; Fischetti, M.; Santangelo, G.; Fracassi, A.; D'Ippolito, G.; Aguzzoli, L.; Mandato, V. D.; Giannella, L.; Scaffa, C.; Falcone, F.; Borghi, C.; Malzoni, M.; Giannini, A.; Salerno, M. G.; Liberale, V.; Contino, B.; Donfrancesco, C.; Desiato, M.; Perrone, A. M.; Dondi, G.; 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.; Dessiole, S.; Carlea, A.; Zullo, F.; Muschiato, B.; Palomba, S.; Greggi, S.; Spinillo, A.; Ghezzi, F.; Colacurci, N.; Angioli, R.; Panici, P. B.; Muzii, L.; Scambia, G.; Raspagliesi, F.; Di Donato, V.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11383/2136628
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