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. 2024 Apr;110(2):139-145.
doi: 10.1177/03008916231208344. Epub 2023 Nov 17.

HPV-related lesions after hysterectomy for high-grade cervical intraepithelial neoplasia and early-stage cervical cancer: A focus on the potential role of vaccination

Giorgio Bogani  1 , Francesco Sopracordevole  2 , Andrea Ciavattini  3 , Alessandro Ghelardi  4 , Enrico Vizza  5 , Paolo Vercellini  6 , Jvan Casarin  7 , Ciro Pinelli  7 , Fabio Ghezzi  7 , Rosa De Vincenzo  8 , Violante Di Donato  9 , Tullio Golia D'augè  9 , Andrea Giannini  9 , Flavia Sorbi  10 , Marco Petrillo  11 , Giampiero Capobianco  11 , Giuseppe Vizzielli  2 , Stefano Restaino  12 , Stefano Cianci  13 , Giovanni Scambia  8 , Francesco Raspagliesi  1
Affiliations

HPV-related lesions after hysterectomy for high-grade cervical intraepithelial neoplasia and early-stage cervical cancer: A focus on the potential role of vaccination

Giorgio Bogani et al. Tumori. 2024 Apr.

Abstract

Objective: To date, no data supports the execution of vaccination after hysterectomy for high-grade cervical intraepithelial neoplasia (CIN2+) and early-stage cervical cancer. We aim to evaluate the potential effect of vaccination after hysterectomy for high-grade cervical intraepithelial neoplasia and early-stage cervical cancer.

Methods: 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 cervical cancer.

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 cervical cancer, 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 type(s)).

Conclusions: 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.

Keywords: HPV; cervical cancer; hysterectomy; vaccination.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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