Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison

Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison

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Background: Primary prevention through vaccination is a prophylactic approach aiming to reduce the risk of developing human papillomavirus (HPV)-related lesions.No mature and long-term data supported the adoption of vaccination in women undergoing conization.Methods: This is a retrospective multi-institutional study.Charts of consecutive patients undergoing conization between 2010 and 2014 were collected.All patients included had at least 5 years of follow-up.

We compared outcomes of patients undergoing conization plus vaccination and conization socialstudiesscholar.com alone.A propensity-score matching algorithm was applied in order to reduce allocation biases.The risk of developing recurrence was estimated using Kaplan-Meir and Cox hazard models.Results: Overall, charts of 1914 women were analyzed.The study group included 116 (6.

1%) and 1798 (93.9%) women undergoing conization plus vaccination and conization alone, respectively.Five-year recurrence rate was 1.7% (n = 2) and 5.7% (n = 102) after conization plus vaccination and conization alone, respectively (p = 0.

068).After the application of a propensity-score matching, we selected 100 patients undergoing conization plus vaccination and 200 patients undergoing conization alone.The crude number of recurrences was 2 (2%) and 11 (5.5%) for patients undergoing conization plus vaccination and conization alone, sukrensi.com respectively (p = 0.231).

Vaccination had no impact on persistent lesions (no negative examination between conization and new cervical dysplasia; p = 0.603), but reduced the risk of recurrent disease (patients who had at least one negative examination between conization and the diagnosis of recurrent cervical dysplasia; p = 0.031).Conclusions: Patients having vaccination experience a slightly lower risk of recurrence than women who had not, although not statistically significantly different.Further evidence is needed to assess the cost effectiveness of adopting vaccination in this setting.