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Long-Term Follow-Up Outcomes in Women with In Situ/Microinvasive Adenocarcinoma of the Uterine Cervix Undergoing Conservative Treatment-Cervical Adenocarcinoma Study Group Italian Society of Colposcopy and Cervico-Vaginal Pathology.

Authors :
Giannella L
Delli Carpini G
Di Giuseppe J
Grelloni C
Bogani G
Dri M
Sopracordevole F
Clemente N
Giorda G
De Vincenzo R
Evangelista MT
Gardella B
Dominoni M
Monti E
Alessi C
Alessandrini L
Guerriero A
Pagan A
Caretto M
Ghelardi A
Amadori A
Origoni M
Barbero M
Raspagliesi F
Simoncini T
Vercellini P
Spinillo A
Scambia G
Ciavattini A
Source :
Cancers [Cancers (Basel)] 2024 Mar 21; Vol. 16 (6). Date of Electronic Publication: 2024 Mar 21.
Publication Year :
2024

Abstract

Objective: The present study aimed to assess long-term follow-up outcomes in women with in situ/microinvasive adenocarcinoma (AC) of the uterine cervix treated conservatively.<br />Methods: Retrospective multi-institutional study including women with early glandular lesions and 5-year follow-up undergoing fertility-sparing treatment. Independent variables associated with recurrence were evaluated. Logistic regression analysis and Kaplan-Meier survival analysis with Logrank test were performed.<br />Results: Of 269 women diagnosed with in situ/microinvasive AC, 127 participants underwent conservative treatment. During follow-up, recurrences were found in nine women (7.1%). The only factor associated with recurrence during follow-up was positive high-risk Human Papillomavirus (hr-HPV) testing (odds ratio 6.21, confidence interval 1.47-26.08, p = 0.012). HPV positivity in follow-up showed a recurrence rate of 21.7% against 3.8% in patients who were HPV-negative ( p = 0.002, Logrank test). Among women with negative high-risk HPV tests in follow-up, recurrences occurred in 20.0% of non-usual-type histology vs. 2.1% of usual-type cases ( p = 0.005).<br />Conclusion: HPV testing in follow-up is of pivotal importance in women with early glandular lesions undergoing conservative treatment, given its recurrence predictive value. However, women who are high-risk HPV-negative in follow-up with non-usual-type histopathology may represent a sub-population at increased risk of recurrences. Further studies should confirm these findings.

Details

Language :
English
ISSN :
2072-6694
Volume :
16
Issue :
6
Database :
MEDLINE
Journal :
Cancers
Publication Type :
Academic Journal
Accession number :
38539572
Full Text :
https://doi.org/10.3390/cancers16061241