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
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 undergoin...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/6/1241 |
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| author | Luca Giannella Giovanni Delli Carpini Jacopo Di Giuseppe Camilla Grelloni Giorgio Bogani Marco Dri Francesco Sopracordevole Nicolò Clemente Giorgio Giorda Rosa De Vincenzo Maria Teresa Evangelista Barbara Gardella Mattia Dominoni Ermelinda Monti Chiara Alessi Lara Alessandrini Angela Guerriero Alessio Pagan Marta Caretto Alessandro Ghelardi Andrea Amadori Massimo Origoni Maggiorino Barbero Francesco Raspagliesi Tommaso Simoncini Paolo Vercellini Arsenio Spinillo Giovanni Scambia Andrea Ciavattini |
| author_facet | Luca Giannella Giovanni Delli Carpini Jacopo Di Giuseppe Camilla Grelloni Giorgio Bogani Marco Dri Francesco Sopracordevole Nicolò Clemente Giorgio Giorda Rosa De Vincenzo Maria Teresa Evangelista Barbara Gardella Mattia Dominoni Ermelinda Monti Chiara Alessi Lara Alessandrini Angela Guerriero Alessio Pagan Marta Caretto Alessandro Ghelardi Andrea Amadori Massimo Origoni Maggiorino Barbero Francesco Raspagliesi Tommaso Simoncini Paolo Vercellini Arsenio Spinillo Giovanni Scambia Andrea Ciavattini |
| author_sort | Luca Giannella |
| collection | DOAJ |
| description | 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, <i>p</i> = 0.012). HPV positivity in follow-up showed a recurrence rate of 21.7% against 3.8% in patients who were HPV-negative (<i>p</i> = 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 (<i>p</i> = 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. |
| first_indexed | 2024-04-24T18:27:16Z |
| format | Article |
| id | doaj.art-c63a08a985ef4a24984993beaba0a585 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-04-24T18:27:16Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c63a08a985ef4a24984993beaba0a5852024-03-27T13:30:12ZengMDPI AGCancers2072-66942024-03-01166124110.3390/cancers16061241Long-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 PathologyLuca Giannella0Giovanni Delli Carpini1Jacopo Di Giuseppe2Camilla Grelloni3Giorgio Bogani4Marco Dri5Francesco Sopracordevole6Nicolò Clemente7Giorgio Giorda8Rosa De Vincenzo9Maria Teresa Evangelista10Barbara Gardella11Mattia Dominoni12Ermelinda Monti13Chiara Alessi14Lara Alessandrini15Angela Guerriero16Alessio Pagan17Marta Caretto18Alessandro Ghelardi19Andrea Amadori20Massimo Origoni21Maggiorino Barbero22Francesco Raspagliesi23Tommaso Simoncini24Paolo Vercellini25Arsenio Spinillo26Giovanni Scambia27Andrea Ciavattini28Woman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, ItalyWoman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, ItalyWoman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, ItalyWoman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, ItalyGynecological Oncology Unit, Fondazione IRCCS—Istituto Nazionale Tumori, 20133 Milan, ItalyGynecological Oncology Unit, Fondazione IRCCS—Istituto Nazionale Tumori, 20133 Milan, ItalyGynecologic Oncology Unit, IRCCS—Centro di Riferimento Oncologico di Aviano, 33081 Aviano, ItalyGynecologic Oncology Unit, IRCCS—Centro di Riferimento Oncologico di Aviano, 33081 Aviano, ItalyGynecologic Oncology Unit, IRCCS—Centro di Riferimento Oncologico di Aviano, 33081 Aviano, ItalyDipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyDepartment of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, 27100 Pavia, ItalyDepartment of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, 27100 Pavia, ItalyGynecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyUOC Ostetricia Ginecologia, Dipartimento per la Salute della Donna e del Bambino, Azienda Ospedaliera—Università di Padova, 35128 Padova, ItalyPathological Anatomy Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, ItalyPathological Anatomy Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, ItalyUOSD di Patologia Cervico-Vaginale, ULSS 2 Marca Trevigiana, 31100 Treviso, ItalyDivision of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyAzienda Usl Toscana Nord-Ovest, UOC Ostetricia e Ginecologia, Ospedale Apuane, 54100 Massa, ItalyGynecology Unit, Ospedale di Forlì, 47121 Forlì, ItalyDepartment of Gynecology & Obstetrics, Vita Salute San Raffaele University School of Medicine, 20132 Milan, ItalyDepartment of Obstetrics and Gynecology, Asti Community Hospital, 14100 Asti, ItalyGynecological Oncology Unit, Fondazione IRCCS—Istituto Nazionale Tumori, 20133 Milan, ItalyDivision of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyGynecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, 27100 Pavia, ItalyDipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, ItalyWoman’s Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, 60123 Ancona, ItalyObjective: 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, <i>p</i> = 0.012). HPV positivity in follow-up showed a recurrence rate of 21.7% against 3.8% in patients who were HPV-negative (<i>p</i> = 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 (<i>p</i> = 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.https://www.mdpi.com/2072-6694/16/6/1241adenocarcinoma in situmicroinvasive adenocarcinomauterine cervixfollow-upconservative treatmenthuman papillomavirus testing |
| spellingShingle | Luca Giannella Giovanni Delli Carpini Jacopo Di Giuseppe Camilla Grelloni Giorgio Bogani Marco Dri Francesco Sopracordevole Nicolò Clemente Giorgio Giorda Rosa De Vincenzo Maria Teresa Evangelista Barbara Gardella Mattia Dominoni Ermelinda Monti Chiara Alessi Lara Alessandrini Angela Guerriero Alessio Pagan Marta Caretto Alessandro Ghelardi Andrea Amadori Massimo Origoni Maggiorino Barbero Francesco Raspagliesi Tommaso Simoncini Paolo Vercellini Arsenio Spinillo Giovanni Scambia Andrea Ciavattini 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 Cancers adenocarcinoma in situ microinvasive adenocarcinoma uterine cervix follow-up conservative treatment human papillomavirus testing |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | adenocarcinoma in situ microinvasive adenocarcinoma uterine cervix follow-up conservative treatment human papillomavirus testing |
| url | https://www.mdpi.com/2072-6694/16/6/1241 |
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