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1320 Assessing the effect of nonavalent HPV-vaccination after hysterectomy for high-grade cervical intraepithelial neoplasia and early-stage cervical cancer
  1. Ilaria Cuccu1,2,
  2. Violante Di Donato1,
  3. Andrea Giannini1,
  4. Francesco Sopracordevole3,
  5. Andrea Ciavattini4,
  6. Enrico Vizza5,
  7. Jvan Casarin6,
  8. Fabio Ghezzi6,
  9. Paolo Vercellini7,
  10. Ciro Pinelli6,
  11. Tullio Golia D’Augè1,
  12. Emanuele De Angelis1,
  13. Marco Petrillo8,
  14. Giampiero Capobianco8,
  15. Giuseppe Vizzielli2,
  16. Stefano Restaino9,
  17. Giovanni Scambia10,
  18. Ludovico Muzii1,
  19. Francesco Raspagliesi2 and
  20. Giorgio Bogani2
  1. 1Department of Gynecological, Obstetrical and Urological Sciences, Sapienza University of Rome, Rome, Italy
  2. 2IRCCS National Cancer Institute, Milano, Italy
  3. 3Department of Gynecological, 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,, Roma, Italy
  6. 6Department of Obstetrics and Gynecology, ‘Filippo Del Ponte’ Hospital, University of Insubria, Ospedale di circolo Fondazione MacchI, Varese, Italy
  7. 7Gynaecology Unit, Fondazione Ca’ Granda Ospedale Maggiore Policlinico,, Milan, Italy
  8. 8Department of Obstetrics and Gynecology. University of Sassari, Sassari, Italy
  9. 9Department of Medical Area (DAME), Clinic of Obstretics and Gynecology Santa Maria della Misericordia, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, Udine, Italy
  10. 10UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, Roma, Italy


Introduction/Background Human papillomavirus (HPV) is one of the most common sexually transmitted diseases, worldwide. In most cases, HPV correlates with transient infections, but its persistence can lead to precancerous and cancerous lesions in various districts. To date, no data supports the execution of vaccination after hysterectomy for high-grade cervical intraepithelial neoplasia (CIN2+) and early-stage cervical cancer (CC). We aim to evaluate the potential effect of vaccination after hysterectomy for high-grade cervical intraepithelial neoplasia and early-stage cervical cancer

Methodology This is a multi-center retrospective study evaluating data of women who develop lower genital tract dysplasia (including anal, vulvar and vaginal intra-epithelial neoplasia) after having hysterectomy for CIN2+ and FIGO stage IA1- IB1 CC

Results Overall, charts for 77 patients who developed lower genital tract dysplasia were collected.The study population included 62 (80.5%) and 15 (19.5%) patients with CIN2+ and early-stage CC, respectively. The median (range) time between hysterectomy and diagnosis of develop lower genital tract dysplasia was 38 (range, 14–62) months. HPV types covered by the nonavalent HPV vaccination would potentially cover 94.8% of the development of lower genital tract dysplasia.Restricting the analysis to the 18 patients with available HPV data at the time of hysterectomy, the beneficial effect of nonvalent vaccination was 89%. However, considering that patients with persistent HPV types (with the same HPV types at the time of hysterectomy and who developed lower genital tract dysplasia) would not benefit from vaccination, we estimated the potential protective effect of vaccination to be 67% (12 out of 18 patients; four patients had a persistent infection for the same HPV types).

Conclusion Our retrospective analysis supported the adoption of HPV vaccination in patients having treatment for HPV-related disease.Even in the absence of the uterine cervix, HPV vaccination would protect against develop lower genital tract dysplasia.Further prospective studies have to confirm our preliminary research.

Disclosures None.

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