Gynecology and Minimally Invasive Therapy

REVIEW ARTICLE
Year
: 2018  |  Volume : 7  |  Issue : 4  |  Page : 145--151

Loop electrosurgical excision procedure versus cryotherapy in the treatment of cervical intraepithelialneoplasia: A systematic review and meta-analysis of randomized controlled trials


Pietro D Alessandro1, Bruno Arduino1, Maria Borgo1, Gabriele Saccone1, Roberta Venturella2, Annalisa Di Cello1, Fulvio Zullo1 
1 Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
2 Department of Obstetrics and Gynaecology, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy

Correspondence Address:
Dr. Gabriele Saccone
Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples
Italy

Aim: Invasive cervical cancer is proceeded by a phase of preinvasive disease that is slow to progress and can be detected, treated, and collectively referred to as cervical intraepithelial neoplasia (CIN). Several excisional and ablative treatments for CIN have been studied, with loop electrosurgical excision procedure (LEEP) and cryotherapy being the two most commonly utilized. The objective of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to compare the compare harms and benefits of LEEP versus cryotherapy in women with CIN. Methods: Electronic databases were searched from their inception until May 2018. We included all RCTs comparing cryotherapy versus LEEP in women with CIN. We included trials evaluating both HIV-seropositive and HIV-seronegative women. The primary outcome was the persistence of the disease at 6-month follow-up. Meta-analysis was performed using the random-effects model to produce summary treatment effects in terms of relative risk (RR) with 95% confidence interval (CI). Results: Four trials, including 1035 women with CIN, were identified as relevant and included in the meta-analysis. Women who received LEEP for CIN had a significantly lower persistence at 6-month follow-up biopsy (RR: 0.87, 95% CI: 0.76–0.99) and significantly lower recurrence at 12-month follow-up biopsy (RR: 0.91, 95% CI: 0.84–0.99) compared to those who received cryotherapy. No between-group differences were found in the complications rate, but the analyses were not powered for these outcomes. Conclusions: In women with CIN, treatment with LEEP was associated with a significantly lower risk of persistence disease at 6 months and recurrence disease at 12 months compared to treatment with cryotherapy.


How to cite this article:
D Alessandro P, Arduino B, Borgo M, Saccone G, Venturella R, Di Cello A, Zullo F. Loop electrosurgical excision procedure versus cryotherapy in the treatment of cervical intraepithelialneoplasia: A systematic review and meta-analysis of randomized controlled trials.Gynecol Minim Invasive Ther 2018;7:145-151


How to cite this URL:
D Alessandro P, Arduino B, Borgo M, Saccone G, Venturella R, Di Cello A, Zullo F. Loop electrosurgical excision procedure versus cryotherapy in the treatment of cervical intraepithelialneoplasia: A systematic review and meta-analysis of randomized controlled trials. Gynecol Minim Invasive Ther [serial online] 2018 [cited 2019 Mar 22 ];7:145-151
Available from: http://www.e-gmit.com/article.asp?issn=2213-3070;year=2018;volume=7;issue=4;spage=145;epage=151;aulast=D;type=0