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. 2024 Mar 21;16(6):1241.
doi: 10.3390/cancers16061241.

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

Luca Giannella  1 , Giovanni Delli Carpini  1 , Jacopo Di Giuseppe  1 , Camilla Grelloni  1 , Giorgio Bogani  2 , Marco Dri  2 , Francesco Sopracordevole  3 , Nicolò Clemente  3 , Giorgio Giorda  3 , Rosa De Vincenzo  4   5 , Maria Teresa Evangelista  4 , Barbara Gardella  6 , Mattia Dominoni  6 , Ermelinda Monti  7 , Chiara Alessi  8 , Lara Alessandrini  9 , Angela Guerriero  9 , Alessio Pagan  10 , Marta Caretto  11 , Alessandro Ghelardi  12 , Andrea Amadori  13 , Massimo Origoni  14 , Maggiorino Barbero  15 , Francesco Raspagliesi  2 , Tommaso Simoncini  11 , Paolo Vercellini  7   16 , Arsenio Spinillo  6 , Giovanni Scambia  4   5 , Andrea Ciavattini  1
Affiliations

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

Luca Giannella et al. Cancers (Basel). .

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.

Keywords: adenocarcinoma in situ; conservative treatment; follow-up; human papillomavirus testing; microinvasive adenocarcinoma; uterine cervix.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Kaplan–Meier survival curves showing recurrence rate in HPV-positive (green line) vs. HPV-negative (blue line) test in follow-up.
See this image and copyright information in PMC

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