Elsevier

Gynecologic Oncology

Volume 130, Issue 2, August 2013, Pages 264-268
Gynecologic Oncology

Is vaccination with quadrivalent HPV vaccine after loop electrosurgical excision procedure effective in preventing recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN2–3)?

https://doi.org/10.1016/j.ygyno.2013.04.050Get rights and content
Under a Creative Commons license
open access

Highlights

  • HPV vaccination after treatment significantly reduces the risk of developing recurrent CIN2–3 related to the vaccine HPV types.

  • HPV vaccination after treatment may be considered in preventing recurrence of CIN2–3.

Abstract

Objectives

This study was conducted to determine whether vaccination with the quadrivalent human papillomavirus (HPV) vaccine after loop electrosurgical excision procedure (LEEP) for high-grade cervical intraepithelial neoplasia (CIN2–3) is effective in preventing recurrence of CIN2–3.

Methods

Between August 2007 and July 2010, 737 patients aged 20–45 years who were diagnosed with CIN2–3 were treated by LEEP and followed. Three hundred and sixty patients were vaccinated with the quadrivalent HPV vaccine after LEEP (vaccination group), and 377 patients were followed without vaccination (non-vaccination group). The vaccination group received the first dose at 1 week after LEEP and the remaining two doses two and six months later. Post-LEEP follow-up was performed at 3, 6, 9, 12, 18, and 24 months during the first 2 years and yearly thereafter.

Results

Irrespective of causal HPV type, 36 (4.9%) patients developed recurrence. In the vaccination group (360 patients), 9 patients (2.5%) developed recurrence, whereas 27 patients (7.2%) in the non-vaccination group (377 patients) developed recurrence. In patients infected with HPV of 16 and/or 18 type, 5 patients (2.5%) in the vaccination group (197 patients) and 18 patients (8.5%) in the non-vaccination group (211 patients) developed recurrent disease related to vaccine HPV types (HPV 16 or 18 types) after LEEP (P < 0.01). Multivariate analysis showed that no vaccination after LEEP was an independent risk factor for recurrent CIN2–3 (HR = 2.840; 95% confidence interval, 1.335–6.042; P < 0.01).

Conclusions

Vaccination with the quadrivalent HPV vaccine after treatment may be considered in preventing recurrence of CIN2–3.

Keywords

High grade CIN
HPV
LEEP
Vaccine

Cited by (0)