Abstract
Objective: To assess the effectiveness of cone biopsy, cryotherapy, laser ablation and the loop electrosurgical procedure in the treatment of squamous intraepithelial lesions. Method: Systematic review of randomized controlled trials in subjects who underwent treatment of low- and high-grade squamous intraepithelial lesions with these modalities. Main outcome measures included the following: percent resolution and persistence of a lesion and notable complications for each procedure. Result: Pooled rates of resolution for low-grade, high-grade, or combined squamous intraepithelial lesions were similar across the different treatment modalities (range 85.2-94.7%), with substantial overlap among the 95% confidence intervals. Significant hemorrhage occurred most frequently in subjects who received cone biopsy (4.6%) (95% CI: 2.15, 6.99), followed by laser ablation (1.75%) (95% CI: 0.70, 2.81), and LEEP (1.35%) (95% CI: 0.24, 2.47). No hemorrhages were reported among subjects who received cryotherapy. Study sample sizes were relatively small. There were no reported cases of progression to invasive cancer, but duration of follow-up (median follow-up time for all eligible studies=12 months) was not sufficient to evaluate long-term outcomes. Conclusions: There were no substantive differences in outcomes regarding persistence and resolution in the treatment of squamous intraepithelial lesions for subjects receiving cone biopsy, cryotherapy, laser ablation, or LEEP. Copyright (C) 2000 International Federation of Gynecology and Obstetrics.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 25-33 |
| Number of pages | 9 |
| Journal | International Journal of Gynecology and Obstetrics |
| Volume | 68 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2000 |
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Keywords
- Cone biopsy
- Cryotherapy
- Laser ablation
- Loop electrosurgical procedure
- Squamous intraepithelial lesions
ASJC Scopus subject areas
- Obstetrics and Gynecology
Cite this
Treatment outcomes for squamous intraepithelial lesions. / Nuovo, James; Melnikow, Joy; Willan, A. R.; Chan, B. K S.
In: International Journal of Gynecology and Obstetrics, Vol. 68, No. 1, 01.01.2000, p. 25-33.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment outcomes for squamous intraepithelial lesions
AU - Nuovo, James
AU - Melnikow, Joy
AU - Willan, A. R.
AU - Chan, B. K S
PY - 2000/1/1
Y1 - 2000/1/1
N2 - Objective: To assess the effectiveness of cone biopsy, cryotherapy, laser ablation and the loop electrosurgical procedure in the treatment of squamous intraepithelial lesions. Method: Systematic review of randomized controlled trials in subjects who underwent treatment of low- and high-grade squamous intraepithelial lesions with these modalities. Main outcome measures included the following: percent resolution and persistence of a lesion and notable complications for each procedure. Result: Pooled rates of resolution for low-grade, high-grade, or combined squamous intraepithelial lesions were similar across the different treatment modalities (range 85.2-94.7%), with substantial overlap among the 95% confidence intervals. Significant hemorrhage occurred most frequently in subjects who received cone biopsy (4.6%) (95% CI: 2.15, 6.99), followed by laser ablation (1.75%) (95% CI: 0.70, 2.81), and LEEP (1.35%) (95% CI: 0.24, 2.47). No hemorrhages were reported among subjects who received cryotherapy. Study sample sizes were relatively small. There were no reported cases of progression to invasive cancer, but duration of follow-up (median follow-up time for all eligible studies=12 months) was not sufficient to evaluate long-term outcomes. Conclusions: There were no substantive differences in outcomes regarding persistence and resolution in the treatment of squamous intraepithelial lesions for subjects receiving cone biopsy, cryotherapy, laser ablation, or LEEP. Copyright (C) 2000 International Federation of Gynecology and Obstetrics.
AB - Objective: To assess the effectiveness of cone biopsy, cryotherapy, laser ablation and the loop electrosurgical procedure in the treatment of squamous intraepithelial lesions. Method: Systematic review of randomized controlled trials in subjects who underwent treatment of low- and high-grade squamous intraepithelial lesions with these modalities. Main outcome measures included the following: percent resolution and persistence of a lesion and notable complications for each procedure. Result: Pooled rates of resolution for low-grade, high-grade, or combined squamous intraepithelial lesions were similar across the different treatment modalities (range 85.2-94.7%), with substantial overlap among the 95% confidence intervals. Significant hemorrhage occurred most frequently in subjects who received cone biopsy (4.6%) (95% CI: 2.15, 6.99), followed by laser ablation (1.75%) (95% CI: 0.70, 2.81), and LEEP (1.35%) (95% CI: 0.24, 2.47). No hemorrhages were reported among subjects who received cryotherapy. Study sample sizes were relatively small. There were no reported cases of progression to invasive cancer, but duration of follow-up (median follow-up time for all eligible studies=12 months) was not sufficient to evaluate long-term outcomes. Conclusions: There were no substantive differences in outcomes regarding persistence and resolution in the treatment of squamous intraepithelial lesions for subjects receiving cone biopsy, cryotherapy, laser ablation, or LEEP. Copyright (C) 2000 International Federation of Gynecology and Obstetrics.
KW - Cone biopsy
KW - Cryotherapy
KW - Laser ablation
KW - Loop electrosurgical procedure
KW - Squamous intraepithelial lesions
UR - http://www.scopus.com/inward/record.url?scp=0033992306&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033992306&partnerID=8YFLogxK
U2 - 10.1016/S0020-7292(99)00162-9
DO - 10.1016/S0020-7292(99)00162-9
M3 - Article
C2 - 10687833
AN - SCOPUS:0033992306
VL - 68
SP - 25
EP - 33
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
SN - 0020-7292
IS - 1
ER -