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Indication of prophylactic vaccines as a tool for secondary prevention in HPV-linked disease

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To determine whether quadrivalent HPV vaccination is effective in reducing recurrent disease in women with a previous history of HPV disease.

Methods

All women under 45 years of age treated for HPV-linked disease and with negative HPV test, cytology and colposcopy 3 months after treatment were enrolled. Women were randomly assigned into two groups: a group that received HPV vaccine post treatment and a group that was only submitted to follow-up. Follow-up was performed every 6 months for a duration of at least 3 years. Kaplan–Meier curve was used to estimate the overall disease-free survival during the follow-up period. Statistical analysis was performed by Fisher’s exact test.

Results

From November 2013 to October 2014, we enrolled a total of 178 women at Careggi University Hospital in Florence and at Azienda USL in Massa Carrara. 12 out of 89 patients in the non-vaccination group recurred (13.5%), while 3 out of 89 patients in the vaccination group recurred (3.4%). The Kaplan–Meier curves showed a statistically difference in the log rank test (p = 0.0147) for the overall disease-free survival in the study groups during follow-up. The rate of recurrence was significantly higher in the non-vaccination group, with a p = 0.0279 by Fisher exact test.

Conclusion

The introduction of anti-HPV vaccination during the follow-up post treatment for HPV-linked disease is recommended to reduce the risk of recurrence. The clinical implication of this could be very important to influence post-treatment management of HPV disease.

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Funding

This was funded by research grants of Fondazione Cassa di Risparmio di Florence

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Authors and Affiliations

  1. Division of Obstetrics and Gynecology, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Annalisa Pieralli, Claudia Bianchi, Noemi Auzzi, Maria Grazia Fallani, Cecilia Bussani, Massimiliano Fambrini, Giuseppe Cariti, Gianfranco Scarselli & Felice Petraglia

  2. Azienda USL-1 Massa e Carrara, Via Minzoni Don Giovanni 3, 54033, Carrara, MS, Italy

    Alessandro Ghelardi

Authors
  1. Annalisa Pieralli
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  2. Claudia Bianchi
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  3. Noemi Auzzi
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  4. Maria Grazia Fallani
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  5. Cecilia Bussani
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  6. Massimiliano Fambrini
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  7. Giuseppe Cariti
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  8. Gianfranco Scarselli
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  9. Felice Petraglia
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  10. Alessandro Ghelardi
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Contributions

Protocol/project development: AP, AG, MF. Conceptualization: AP. Funding acquisition: CB, MF. Data collection and management: CB, NA. Blind colposcopists and physicians: AP, AG, MGF. Blind biologists: CB. Data Analysis: CB, NZ. Manuscript writing/editing: CB, NA, GC, FP. Supervision: GC, FP.

Corresponding author

Correspondence to Claudia Bianchi.

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We declare that we have no conflict of interest.

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Pieralli, A., Bianchi, C., Auzzi, N. et al. Indication of prophylactic vaccines as a tool for secondary prevention in HPV-linked disease. Arch Gynecol Obstet 298, 1205–1210 (2018). https://doi.org/10.1007/s00404-018-4926-y

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  • DOI: https://doi.org/10.1007/s00404-018-4926-y

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