Adjuvant VaccInation After Conization for the Treatment for CervicAL Dysplasia

Abstract

This study aimed to evaluate the role of adjuvant HPV vaccination in women undergoing conization for cervical intraepithelial neoplasia. This prospective study assessed factors influencing recurrence in patients undergoing conization for high-grade cervical dysplasia. After conization, patients were counseled on the potential benefits of vaccination. We compared outcomes between two groups: women who underwent conization with adjuvant human papillomavirus (HPV) vaccination and observation versus conization with observation only. Data from 281 patients were analyzed, comprising 168 (59.8%) patients in the conization-only group and 113 (40.2%) patients in the conization-plus vaccination group. Vaccinated patients were younger than nonvaccinated patients (38 vs. 45 years, P < 0.001). Positive surgical margins were more frequently observed in the vaccinated group compared with the nonvaccinated group (9.7 vs. 3.6%; P = 0.038). Median follow-up was shorter in the vaccinated group, although this difference was not statistically significant (24.9 vs. 27.8 months; P = 0.395). The risk of developing HPV-related lesions was similar between the vaccinated and nonvaccinated groups (P = 0.594, log-rank test). Likewise, the need for reconization did not differ significantly between the groups (P = 0.593, log-rank test). Multivariate analysis showed no significant impact of HPV vaccination on postoperative outcomes [hazard ratio (HR): 0.50, 95% confidence interval (CI): 0.15-1.68) for any lesion; HR: 0.90, 95% CI: 0.47-1.73 for reconization]. This study indicates that adjuvant HPV vaccination does not significantly affect short-term outcomes in women undergoing conization for cervical dysplasia. Ongoing randomized trials will provide more robust evidence to clarify the role of adjuvant vaccination in this setting.

Keywords: adjuvant; cervix HPV; conization; vaccination.