The Association Between Clearance of Human Papillomavirus After Conization for Cervical Cancer and Absence of Cancer. Issue 4 (October 2021)

• Record Type: Journal Article
• Authors: Siegler, Efraim; Goldberg, Yael; Siegler, Yoav; Shaked-Mishan, Pninit; Mazareb, Salam; Kugelman, Nir; Mackuli, Lena; Sabo, Edmond; Lavie, Ofer; Segev, Yakir
• Is Part Of: Journal of lower genital tract disease. Volume 25:Issue 4(2021)
• Publication Date: 2021-10
• Subjects: high-risk human papillomavirus -- large loop excision of the transformation zone -- adenocarcinoma -- adenocarcinoma in situ -- cervical intraepithelial neoplasia -- radical hysterectomy -- cervical cancer; Generative organs, Female -- Diseases -- Periodicals; Cervix uteri -- Diseases -- Periodicals; Generative organs -- Diseases -- Periodicals; Sexually transmitted diseases -- Periodicals; 618.1
• DOI: 10.1097/LGT.0000000000000622
• Languages: English
• ISSNs: 1089-2591

Abstract

Abstract : Objectives: We assessed the relation between clearance of high-risk human papillomavirus (HR-HPV) after large loop excision of the transformation zone (LLETZ) and absence of residual disease, in women diagnosed with cervical cancer (CC) and adenocarcinoma in situ (AIS). Materials Methods: Data were collected from 92 women diagnosed with CC and AIS who were positive to HR-HPV and had a repeat cervical HPV test 3–12 weeks after LLETZ (in which CC/AIS were diagnosed) and before final surgical treatment. We compared characteristics of women with negative and positive HR-HPV after LLETZ. Results: The HR-HPV results after the LLETZ operation were negative in 40 women and positive in 52 women. The HR-HPV–negative group included a significantly higher incidence of AIS: 14 (35%) vs 5 (9.6%, p < .006). In the negative HR-HPV post-LLETZ group, 36 (90%) had normal histology and only 2 (5%) had cancer in the final histological specimen. Among 34 women who underwent radical hysterectomy/trachelectomy after LLETZ, a normal final histology was observed in 75% and 9% of those who were HR-HPV negative and HR-HPV positive, respectively ( p < .0005). The positive predictive value for absence of residual cancer, with clearance of HR-HPV after LLETZ, was 95%. Conclusions: Clearance of HR-HPV from the cervix a short time after LLETZ has a high association with the absence of residual cancer in the final outcome, either in the pathology or the follow-up. Testing for HR-HPV a short time after LLETZ might serve as a parameter for risk assessment.