Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia
Yan-Ming Jiang, Chang-Xian Chen, Li LiDepartment of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of ChinaObjective: This meta-analysis aimed to compare the superiority of loop electrosurgical excision procedure (LEEP) or large lo...
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doaj-daa63e6581024283a2c4e66dc8e0fc0f2020-11-25T01:30:17ZengDove Medical PressOncoTargets and Therapy1178-69302016-06-012016Issue 13907391527669Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasiaJiang YMChen CXLi LYan-Ming Jiang, Chang-Xian Chen, Li LiDepartment of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of ChinaObjective: This meta-analysis aimed to compare the superiority of loop electrosurgical excision procedure (LEEP) or large loop excision of the transformation zone (LLETZ) versus cold-knife conization (CKC) in the surgical treatment of cervical intraepithelial neoplasia (CIN).Methods: Systematic searches were performed in the MEDLINE, EMBASE, Cochrane databases, and the China National Knowledge Infrastructure Databases to identify all potential articles involving patients with CIN treated with LEEP/LLETZ or CKC published up to February 2016. Risk ratios (RRs) or weighted mean difference (MD) with a 95% confidence interval (95% CI) were calculated.Results: Seven randomized controlled trials, one prospective cohort study, and twelve retrospective cohort studies were included in this meta-analysis. There were no significant differences following LEEP/LLETZ compared with CKC in recurrence rate (RR =1.75, 95% CI =0.99–3.11, P=0.06), positive margin rate (RR =1.45; 95% CI =0.85–2.49, P=0.17), residual disease rate (RR =1.15, 95% CI =0.73–1.81, P=0.48), secondary hemorrhage (RR =1.16, 95% CI =0.74–1.81; P=0.46), or cervical stenosis. Moreover, subgroup analyses based on randomized trials also revealed that no statistical significance was observed in the above outcomes. However, women treated with CKC had a significantly deeper cervical cone than those treated with LLETZ/LEEP (MD =−5.71, 95% CI =−7.45 to −3.96; P<0.001).Conclusion: LEEP/LLETZ is as effective as CKC with regard to recurrence rate, positive margin rate, residual disease rate, secondary hemorrhage, and cervical stenosis for the surgical treatment of CIN. Further large-scale studies are needed to confirm our findings.Keywords: cervical intraepithelial neoplasia, cold-knife conization, loop electrosurgical excision procedure, meta-analysishttps://www.dovepress.com/meta-analysis-of-cold-knife-conization-versus-loop-electrosurgical-exc-peer-reviewed-article-OTTcervical intraepithelial neoplasiacold-knife conizationloop electrosurgical excision proceduremeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiang YM Chen CX Li L |
spellingShingle |
Jiang YM Chen CX Li L Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia OncoTargets and Therapy cervical intraepithelial neoplasia cold-knife conization loop electrosurgical excision procedure meta-analysis |
author_facet |
Jiang YM Chen CX Li L |
author_sort |
Jiang YM |
title |
Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia |
title_short |
Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia |
title_full |
Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia |
title_fullStr |
Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia |
title_full_unstemmed |
Meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia |
title_sort |
meta-analysis of cold-knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia |
publisher |
Dove Medical Press |
series |
OncoTargets and Therapy |
issn |
1178-6930 |
publishDate |
2016-06-01 |
description |
Yan-Ming Jiang, Chang-Xian Chen, Li LiDepartment of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of ChinaObjective: This meta-analysis aimed to compare the superiority of loop electrosurgical excision procedure (LEEP) or large loop excision of the transformation zone (LLETZ) versus cold-knife conization (CKC) in the surgical treatment of cervical intraepithelial neoplasia (CIN).Methods: Systematic searches were performed in the MEDLINE, EMBASE, Cochrane databases, and the China National Knowledge Infrastructure Databases to identify all potential articles involving patients with CIN treated with LEEP/LLETZ or CKC published up to February 2016. Risk ratios (RRs) or weighted mean difference (MD) with a 95% confidence interval (95% CI) were calculated.Results: Seven randomized controlled trials, one prospective cohort study, and twelve retrospective cohort studies were included in this meta-analysis. There were no significant differences following LEEP/LLETZ compared with CKC in recurrence rate (RR =1.75, 95% CI =0.99–3.11, P=0.06), positive margin rate (RR =1.45; 95% CI =0.85–2.49, P=0.17), residual disease rate (RR =1.15, 95% CI =0.73–1.81, P=0.48), secondary hemorrhage (RR =1.16, 95% CI =0.74–1.81; P=0.46), or cervical stenosis. Moreover, subgroup analyses based on randomized trials also revealed that no statistical significance was observed in the above outcomes. However, women treated with CKC had a significantly deeper cervical cone than those treated with LLETZ/LEEP (MD =−5.71, 95% CI =−7.45 to −3.96; P<0.001).Conclusion: LEEP/LLETZ is as effective as CKC with regard to recurrence rate, positive margin rate, residual disease rate, secondary hemorrhage, and cervical stenosis for the surgical treatment of CIN. Further large-scale studies are needed to confirm our findings.Keywords: cervical intraepithelial neoplasia, cold-knife conization, loop electrosurgical excision procedure, meta-analysis |
topic |
cervical intraepithelial neoplasia cold-knife conization loop electrosurgical excision procedure meta-analysis |
url |
https://www.dovepress.com/meta-analysis-of-cold-knife-conization-versus-loop-electrosurgical-exc-peer-reviewed-article-OTT |
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