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2022-RA-733-ESGO Duration of HPV persistence and its relationship with recurrent cervical dysplasia
  1. Giuseppe Capalbo1,
  2. Violante DI Donato2,
  3. Francesco Sopracordevole3,
  4. Andrea Ciavattini4,
  5. Benito Chiofalo5,
  6. Enrico Vizza6,
  7. Paolo Vercellini7,
  8. Fabio Ghezzi8,
  9. Giovanni Scambia9,
  10. Francesco Raspagliesi10,
  11. Innocenza Palaia11,
  12. Pierluigi Benedetti Panici11,
  13. Ludovico Muzii11 and
  14. Giorgio Bogani11
  1. 1Department of Gynecological, Obstetrical and Urological Sciences, ‘Sapienza’ University of Rome, Rome, Italy
  2. 2Department of Gynecological, Obstetrical and Urological Sciences., ‘Sapienza’ University of Rome, Rome, Italy
  3. 3Gynecological Oncology Unit, Centro di Riferimento Oncologico – National Cancer Institute, Aviano, Italy
  4. 4Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
  5. 5Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS ‘Regina Elena’ National Cancer Institute, Rome, Italy
  6. 6Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS ‘Regina Elena’ National Cancer Institute., Rome, Italy
  7. 7Gynaecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico., Milan, Italy
  8. 8Department of Obstetrics and Gynecology, ‘Filippo Del Ponte’ Hospital, University of Insubria; Ospedale di circolo Fondazione Macchi, Varese, Italy, Varese, Italy
  9. 9UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubb, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy, Rome, Italy
  10. 10Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
  11. 11Department of Gynecological, Obstetrical and Urological Sciences, ‘Sapienza’ University of Rome, Rome, Italy


Introduction/Background HPV persistence after conization represent one of the most important risk factors for disease recurrence. However, no data regarding the impact of duration of HPV persistence are still available. Here, we aim to evaluate the how duration of HPV persistence influence the risk of developing recurrent high-grade cervical dysplasia (CIN2+).

Methodology Data of patients with persistent HPV infection (at least at 6 months) after primary conization were extracted from a multi-institutional Italian database, retrospectively. Kaplan-Meier and Cox proportional hazards models were used to evaluate associations between duration of HPV persistence with the 5-year risk of developing recurrent CIN2+.

Results Overall, 545 patients met the inclusion criteria. Positive margins were detected in 160 (29.3%) patients. Overall, 247 (45.3%) and 123 (22.6%) patients had a documented infection from HPV16/18, and other HR-HPV types. 187 (34.3%), 73 (13.4%), and 40 (7.3%) were diagnosed with persistent HPV infection at 12-, 18-, and 24-month, respectively. Patients with HPV persistence at 6-month experienced a risk of recurrence of 7.46%. Twelve-month HPV persistence strongly correlates with the risk of developing the recurrent disease (risk of recurrence: 13.1%). While, having HPV persistence >12 months did not correlate with an increased risk of recurrence (HR: 1.34 (95%CI: 0.78, 2.32); p=0.336, log-rank test).

Conclusion HPV persistence is one of the most important factor predicting the risk of CIN2+ recurrence. The risk of CIN2+ recurrence increased by the increase of HPV persistence up to one year. The persistence of HPV after the first year does not appear as a risk factor

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