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)?

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, 1335-6.042; P < 0.01). Conclusions. Vaccination with the quadrivalent HPV vaccine after treatment may be considered in preventing recurrence of CIN2-3. (c) 2013 The Authors. Published by Elsevier Inc. All right reserved.