Short-Term Efficacy of Trichloroacetic Acid in the Treatment of Cervical Intraepithelial Neoplasia

Geisler, Stephanie; Speiser, Sophie; Speiser, Lukas; Heinze, Georg; Rosenthal, Adam; Speiser, Paul

doi:10.1097/aog.0000000000001244

Cited by 18 publications

(12 citation statements)

References 17 publications

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“…Photodynamic therapy using a topical hexyl-aminolevulinic acid (ALA) cream followed by the application of a light-emitting device by the patient herself, had only a limited effect [6,7]. Corrosive treatment of the cervical surface with topical 85% trichloroacetic acid in an outpatient setting showed promising results, but with not negligible vasovagal symptoms immediately after treatment [8]. Recently, an aqueous hydrocolloid vaginal gel was developed, containing highly dispersed silicon dioxide and DEFLAMIN® as active agents.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of an adsorbent and anti-oxidative vaginal gel on CIN1 and 2, on high-risk HPV, and on p16/Ki-67: a randomized controlled trial

Major

Dvořák²,

Schwarzová³

et al. 2020

Arch Gynecol Obstet

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Purpose The effect of SAM vaginal gel, a medical device containing adsorptive silicon dioxide and antioxidative sodium selenite and citric acid, on histologically-proven cervical intraepithelial neoplasia type 2 (CIN2) as well as p16 positive CIN1, and on the presence of the onco-marker p16 was investigated. Methods 216 women aged 25–60 years were randomized to either receive an intravaginal daily dose of SAM gel for three 28-day periods, or be followed-up without intervention. The primary endpoint was efficacy, defined as a combined histological and cytological regression. At baseline and after 3 months participants had: a guided biopsy including p16 immunohistochemical (IHC) staining, only if a lesion was visible at colposcopy; a cervical smear for cytology, high-risk human papillomavirus (hr-HPV) and a p16/Ki-67 test. At 6 months a further cytology and p16/Ki-67 test was performed. Results Regression of CIN lesions was observed in 78 out of 108 patients (72.2%) in the SAM gel arm and in 27 out of 108 patients (25.0%) in the control arm. Similarly, the change in the p16/Ki-67 cytological test status was significantly in favor of the treatment arm. The prevalence of hr-HPV decreased significantly (p < 0.001) in the treatment arm, from 87.0% to 39.8%, while it slightly increased in the control arm, from 78.7% to 83.3%. At 6 months the cytological regression in the treatment group and the highly significant effect on p16/Ki-67 was still present. Conclusion SAM vaginal gel enhances the regression of cervical lesions and clears hr-HPV and p16/Ki-67 in smears significantly, thus offering an active non-destructive management to prevent cervical cancer. Trial registration number ISRCTN11009040, date of registration: 10/12/2019; https://doi.org/10.1186/ISRCTN11009040; retrospectively registered.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of an adsorbent and anti-oxidative vaginal gel on CIN1 and 2, on high-risk HPV, and on p16/Ki-67: a randomized controlled trial

Major

Dvořák²,

Schwarzová³

et al. 2020

Arch Gynecol Obstet

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“…Computer aided data optimisation has been applied, at various levels of sophistication and automation in DC voltammetry, to relatively simple problems requiring the estimation of no more than about five parameters (see for example,,, and references cited therein). Typically in DC voltammetry with automated data optimisation, each experimental data set is interrogated using a particular simulation model and say four parameters such as E 0 , k 0 , α, and D (diffusion coefficient) in the case of a simple solution soluble electron transfer reaction as reported by Scharbert and Speiser .…”

Section: Introductionmentioning

confidence: 99%

Integration of Heuristic and Automated Parametrization of Three Unresolved Two‐Electron Surface‐Confined Polyoxometalate Reduction Processes by AC Voltammetry

et al. 2018

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The thermodynamic and electrode kinetic parameters that describe each of the three unresolved proton‐coupled two‐electron transfer processes of surface‐confined Keggin‐type phosphomolybdate, [PMo12O40]3− adsorbed onto glassy carbon electrode in 1.0 M H2SO4 have been elucidated by comparison of experimental and simulated AC voltammmetric data. Modelling of this problem requires the introduction of over 30 parameters, although this may be reduced to about half this number when intelligent forms of data analysis are introduced. Heuristic (i. e., an experimenter based trial and error method) and automated data optimization approaches are integrated in this very extensive parameter estimation exercise. However, obtaining a unique solution remains challenging for reasons that are outlined. In the final analysis and using the automated strategy, estimates of six reversible potentials, lower limits of the six electron transfer rate constants, the double layer capacitance, uncompensated resistance and surface coverage are reported, with others (such as the charge transfer co‐efficient) present in the model being unobtainable for reasons that are provided. The fit to experimental data using parameters obtained by automated data optimisation is excellent and slightly superior to that obtained by heuristic analysis. The parameters obtained by either method account for differences in shapes and current magnitudes of each of the overall two electron processes.

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“…Generally, TCA has low viscosity; therefore, special attention is required because it can easily drip down onto normal tissue, which can also become chemically coagulated. Therefore, when managing CIN, the wooden stick end of the cotton swab saturated with trichloroacetic acid is carefully applied [1]. The TCA should be handled very carefully even when used in treatment at the medical office and also with care in drug placement and administration as a high hazard medicine.…”

Section: Discussionmentioning

confidence: 99%

“…for cervical intraepithelial neoplasia Geisler et al (2016). demonstrated that a high regression and remission rate and a high HPV clearance rate were observed 8 weeks after topical 85% trichloroacetic acid treatment for patients with CIN[1].However, numerous studies have been reported about the risk of chemical burn related TCA[2,3]. Ryu et al not-ed that Acetic acid (37%) was the most common cause of chemical burns treated in a single hospital study between 2000 and 2009, followed by Hydrofluoric acid (20%),…”

mentioning

confidence: 99%

Accidental Trichloroacetic Acid Burn Injuries on Genital Area during Gynecological Procedures

Lee

Kim

2021

J Korean Burn Soc

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TCA is widely used in cosmetic treatments such as chemical peels, tattoo removal, and also in gynecological procedures for managing cervical intraepithelial neoplasia. However, storage of high concentration of TCA in a gynecology office is a potential hazard, as it may accidentally cause severe chemical burns. We report a case of deep dermal TCA chemical burn on genital area, which occured accidentally and resulted from misuse of high concentration (90%) of TCA coated vaginal gauze packing dressing during gynecological procedures.

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Short-Term Efficacy of Trichloroacetic Acid in the Treatment of Cervical Intraepithelial Neoplasia

Abstract: A high regression and remission rate and a high HPV clearance rate were observed 8 weeks after topical 85% trichloroacetic acid treatment for patients with CIN.

Cited by 18 publications

References 17 publications

Efficacy and safety of an adsorbent and anti-oxidative vaginal gel on CIN1 and 2, on high-risk HPV, and on p16/Ki-67: a randomized controlled trial

Efficacy and safety of an adsorbent and anti-oxidative vaginal gel on CIN1 and 2, on high-risk HPV, and on p16/Ki-67: a randomized controlled trial

Integration of Heuristic and Automated Parametrization of Three Unresolved Two‐Electron Surface‐Confined Polyoxometalate Reduction Processes by AC Voltammetry

Accidental Trichloroacetic Acid Burn Injuries on Genital Area during Gynecological Procedures

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