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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.
Giannella, Luca; Delli Carpini, Giovanni; Di Giuseppe, Jacopo; Grelloni, Camilla; Bogani, Giorgio; Dri, Marco; Sopracordevole, Francesco; Clemente, Nicolò; Giorda, Giorgio; De Vincenzo, Rosa; Evangelista, Maria Teresa; Gardella, Barbara; Dominoni, Mattia; Monti, Ermelinda; Alessi, Chiara; Alessandrini, Lara; Guerriero, Angela; Pagan, Alessio; Caretto, Marta; Ghelardi, Alessandro; Amadori, Andrea; Origoni, Massimo; Barbero, Maggiorino; Raspagliesi, Francesco; Simoncini, Tommaso; Vercellini, Paolo; Spinillo, Arsenio; Scambia, Giovanni; Ciavattini, Andrea.
Afiliación
  • Giannella L; Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, Italy.
  • Delli Carpini G; Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, Italy.
  • Di Giuseppe J; Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, Italy.
  • Grelloni C; Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, Italy.
  • Bogani G; Gynecological Oncology Unit, Fondazione IRCCS-Istituto Nazionale Tumori, 20133 Milan, Italy.
  • Dri M; Gynecological Oncology Unit, Fondazione IRCCS-Istituto Nazionale Tumori, 20133 Milan, Italy.
  • Sopracordevole F; Gynecologic Oncology Unit, IRCCS-Centro di Riferimento Oncologico di Aviano, 33081 Aviano, Italy.
  • Clemente N; Gynecologic Oncology Unit, IRCCS-Centro di Riferimento Oncologico di Aviano, 33081 Aviano, Italy.
  • Giorda G; Gynecologic Oncology Unit, IRCCS-Centro di Riferimento Oncologico di Aviano, 33081 Aviano, Italy.
  • De Vincenzo R; Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
  • Evangelista MT; Dipartimento di Scienze della Vita e Sanita Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
  • Gardella B; Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
  • Dominoni M; Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, 27100 Pavia, Italy.
  • Monti E; Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, 27100 Pavia, Italy.
  • Alessi C; Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
  • Alessandrini L; UOC Ostetricia Ginecologia, Dipartimento per la Salute della Donna e del Bambino, Azienda Ospedaliera-Università di Padova, 35128 Padova, Italy.
  • Guerriero A; Pathological Anatomy Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy.
  • Pagan A; Pathological Anatomy Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy.
  • Caretto M; UOSD di Patologia Cervico-Vaginale, ULSS 2 Marca Trevigiana, 31100 Treviso, Italy.
  • Ghelardi A; Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
  • Amadori A; Azienda Usl Toscana Nord-Ovest, UOC Ostetricia e Ginecologia, Ospedale Apuane, 54100 Massa, Italy.
  • Origoni M; Gynecology Unit, Ospedale di Forlì, 47121 Forlì, Italy.
  • Barbero M; Department of Gynecology & Obstetrics, Vita Salute San Raffaele University School of Medicine, 20132 Milan, Italy.
  • Raspagliesi F; Department of Obstetrics and Gynecology, Asti Community Hospital, 14100 Asti, Italy.
  • Simoncini T; Gynecological Oncology Unit, Fondazione IRCCS-Istituto Nazionale Tumori, 20133 Milan, Italy.
  • Vercellini P; Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
  • Spinillo A; Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
  • Scambia G; Academic Center for Research on Adenomyosis and Endometriosis, Gynecology Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy.
  • Ciavattini A; Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, 27100 Pavia, Italy.
Cancers (Basel) ; 16(6)2024 Mar 21.
Article en En | MEDLINE | ID: mdl-38539572
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.

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.

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).

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cancers (Basel) Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cancers (Basel) Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza