Lyufang Duan1,2, Hui Du1,2, Jerome L Belinson3,4, Zhihong Liu1,2, Aimin Xiao1,2, Shuangyan Liu1,2, Liwei Zhao1,2, Chun Wang1,2, Xinfeng Qu5, Ruifang Wu1,2. 1. Department of Gynecology and Obstetrics, Peking University Shenzhen Hospital, Shenzhen, China. 2. Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, China. 3. Preventive Oncology International, Cleveland Heights, Ohio, USA. 4. Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA. 5. Sanming Project of Medicine in Shenzhen Peking University, Shenzhen Hospital, Shenzhen, China.
Abstract
AIM: To compare thermocoagulation and cryotherapy for treatment of high-grade cervical intraepithelial neoplasia (CIN). METHODS:From May 2017 to May 2018, women with CIN2/3 were randomized to thermocoagulation or cryotherapy at Peking University Shenzhen Hospital. Follow-up at 4 and 8 months included cytology and human papillomavirus (HPV) testing. Women who were HPV-positive or had atypical squamous cells of undetermined significance or higher-grade disease underwent colposcopy/biopsy. RESULTS: Among 149 women enrolled, 74 were randomized to thermocoagulation, and 75 to cryotherapy (excluded four were immediately referred for thermocoagulation due to large lesions). At follow-up, there was no difference between the thermocoagulation and cryotherapy groups in HPV-negative (4/8 months: 72.5%/86.2% vs 68.6%/80.6%) and pathology-negative (97.1%/98.5% vs 94.3%/92.3%) rates (all P > 0.05). The cytology-negative rate was similar for thermocoagulation and cryotherapy at 4 months (79.7% vs 78.9%, P > 0.05), but higher for thermocoagulation at 8 months (100% vs 88.7%, P < 0.05). No lesions were observed among the four referral women at follow-up. As compared with cryotherapy, thermocoagulation was associated with shorter duration of treatment and less vaginal discharge, but higher pain during application and longer bleeding after treatment. CONCLUSION: Thermocoagulation was as effective and safe as cryotherapy and might be easily applied to treat high-grade cervical lesions.
RCT Entities:
AIM: To compare thermocoagulation and cryotherapy for treatment of high-grade cervical intraepithelial neoplasia (CIN). METHODS: From May 2017 to May 2018, women with CIN2/3 were randomized to thermocoagulation or cryotherapy at Peking University Shenzhen Hospital. Follow-up at 4 and 8 months included cytology and human papillomavirus (HPV) testing. Women who were HPV-positive or had atypical squamous cells of undetermined significance or higher-grade disease underwent colposcopy/biopsy. RESULTS: Among 149 women enrolled, 74 were randomized to thermocoagulation, and 75 to cryotherapy (excluded four were immediately referred for thermocoagulation due to large lesions). At follow-up, there was no difference between the thermocoagulation and cryotherapy groups in HPV-negative (4/8 months: 72.5%/86.2% vs 68.6%/80.6%) and pathology-negative (97.1%/98.5% vs 94.3%/92.3%) rates (all P > 0.05). The cytology-negative rate was similar for thermocoagulation and cryotherapy at 4 months (79.7% vs 78.9%, P > 0.05), but higher for thermocoagulation at 8 months (100% vs 88.7%, P < 0.05). No lesions were observed among the four referral women at follow-up. As compared with cryotherapy, thermocoagulation was associated with shorter duration of treatment and less vaginal discharge, but higher pain during application and longer bleeding after treatment. CONCLUSION: Thermocoagulation was as effective and safe as cryotherapy and might be easily applied to treat high-grade cervical lesions.
Authors: Hormuzd A Katki; Mark Schiffman; Philip E Castle; Barbara Fetterman; Nancy E Poitras; Thomas Lorey; Li C Cheung; Tina Raine-Bennett; Julia C Gage; Walter K Kinney Journal: J Low Genit Tract Dis Date: 2013-04 Impact factor: 1.925
Authors: A Aerssens; P Claeys; A Garcia; Y Sturtewagen; R Velasquez; D Vanden Broeck; S Vansteelandt; M Temmerman; C A Cuvelier Journal: Histopathology Date: 2008-02 Impact factor: 5.087
Authors: Evelyne Marie Piret; Beth A Payne; Laurie W Smith; Jessica Trawin; Jackson Orem; Gina Ogilvie; Carolyn Nakisige Journal: Fam Med Community Health Date: 2022-05