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Value-based medicine analysis on loop electrosurgical excision procedure and CO(2) laser vaporization for the treatment of cervical intraepithelial neoplasia 2.
MedLine Citation:
PMID:  22568858     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim:  The best treatment option for cervical intraepithelial neoplasia 2 (CIN2) is controversial and there is a lack of studies in value-based medicine. This multicenter comparative study was undertaken to evaluate the effectiveness, cost-effectives and quality of life (QOL) of loop electrosurgical excision procedure (LEEP) and CO(2) laser vaporization for the treatment of CIN2. Material and Methods:  A database of LEEP and laser vaporizations performed at three research centers was created. Patients with colposcopic-histopathologically confirmed CIN2 were randomly submitted to LEEP and laser vaporization. Cytology, human papilloma virus (HPV) DNA test and histology were performed, and a questionnaire on QOL was filled out during follow-up. Effectiveness, cost-effectives and QOL were analyzed. Results:  Three hundred and thirty-eight women with CIN2 were included in the study. Frequencies of remission, and persistent and recurrent CIN were 89.2%, 7.2%, and 3.6% for LEEP, and 86.7%, 12.6%, 0.70% for laser, respectively. There was no significant difference in remission and persistence of CIN. There was a significant difference in the number of operations, recovery time and costs. Women treated with two methods showed relatively identical QOL. Conclusion:  Both LEEP and CO(2) laser vaporization are effective and reliable treatments for CIN2, whereas cervical tissue can be obtained for histology by LEEP. Preoperative evaluation and postoperative follow-up are important. Gynecologists should pay attention to QOL of patients with CIN.
Authors:
Lu-Lu Sun; Dong-Yan Cao; Jia-Xin Yang; Mei-Lu Bian; Li-Hui Wei; Keng Shen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-8
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  -     ISSN:  1447-0756     ISO Abbreviation:  J. Obstet. Gynaecol. Res.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.
Affiliation:
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College/Chinese Academy of Medical Sciences Department of Obstetrics and Gynecology, China-Japan Friendship Hospital Department of Obstetrics and Gynecology, People's Hospital of Peking University, Beijing, China.
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