Topical 5-fluorouracil for treatment of cervical intraepithelial neoplasia 2: a randomized controlled trial

Rahangdale, Lisa; Lippmann, Quinn K.; Garcia, Katelyn; Budwit, Debra; Smith, Jennifer S.; Le, Linda Van

doi:10.1016/j.ajog.2013.12.042

Cited by 52 publications

(70 citation statements)

References 20 publications

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“…We identified 250 potentially eligible studies; 43 publications met the inclusion criteria (fig 1),6222324252627282930313233343536373839404142434445464748495051525354555657585960616263 but seven were duplicate reports of the same data 27283140505254. Of the 36 eligible studies (total of 3160 women), seven (19%) were randomised trials with suitable data in the non-experimental arm,22253339455762 16 (44%) were prospective cohort studies,6263032343536373841435155566063 and 13 (36%) were retrospective cohort studies23242942444647484953585961 (see supplementary table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 36 eligible studies (total of 3160 women), seven (19%) were randomised trials with suitable data in the non-experimental arm,22253339455762 16 (44%) were prospective cohort studies,6263032343536373841435155566063 and 13 (36%) were retrospective cohort studies23242942444647484953585961 (see supplementary table 2). The median follow-up was 16 months (range 3-72, interquartile range 7.6-27.4 months).…”

Section: Resultsmentioning

confidence: 99%

“…The protocols varied greatly between the studies, and of the 32 studies reporting the protocol, the definite criteria for colposcopic evaluation or histological sampling during the follow-up could not be defined in 11 studies. In the prospective, low risk of bias studies,22252630313335363738434751565763 the most typical protocols included cytology and colposcopy every three to four months, with routine biopsies or biopsies when progression was suspected.…”

Section: Resultsmentioning

confidence: 99%

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Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis

Tainio

Athanasiou

Tikkinen

et al. 2018

BMJ

276

242

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ObjectiveTo estimate the regression, persistence, and progression of untreated cervical intraepithelial neoplasia grade 2 (CIN2) lesions managed conservatively as well as compliance with follow-up protocols.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from 1 January 1973 to 20 August 2016.Eligibility criteriaStudies reporting on outcomes of histologically confirmed CIN2 in non-pregnant women, managed conservatively for three or more months.Data synthesisTwo reviewers extracted data and assessed risk of bias. Random effects model was used to calculate pooled proportions for each outcome, and heterogeneity was assessed using I2 statistics.Main outcome measuresRates of regression, persistence, or progression of CIN2 and default rates at different follow-up time points (3, 6, 12, 24, 36, and 60 months).Results36 studies that included 3160 women were identified (seven randomised trials, 16 prospective cohorts, and 13 retrospective cohorts; 50% of the studies were at low risk of bias). At 24 months, the pooled rates were 50% (11 studies, 819/1470 women, 95% confidence interval 43% to 57%; I2=77%) for regression, 32% (eight studies, 334/1257 women, 23% to 42%; I2=82%) for persistence, and 18% (nine studies, 282/1445 women, 11% to 27%; I2=90%) for progression. In a subgroup analysis including 1069 women aged less than 30 years, the rates were 60% (four studies, 638/1069 women, 57% to 63%; I2=0%), 23% (two studies, 226/938 women, 20% to 26%; I2=97%), and 11% (three studies, 163/1033 women, 5% to 19%; I2=67%), respectively. The rate of non-compliance (at six to 24 months of follow-up) in prospective studies was around 10%.ConclusionsMost CIN2 lesions, particularly in young women (<30 years), regress spontaneously. Active surveillance, rather than immediate intervention, is therefore justified, especially among young women who are likely to adhere to monitoring.Systematic review registrationPROSPERO 2014: CRD42014014406.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis

Tainio

Athanasiou

Tikkinen

et al. 2018

BMJ

276

242

View full text Add to dashboard Cite

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“…5‐fluorouracil is a structural thymidine analogue that interferes with DNA synthesis and is used to treat epithelial malignancies because it acts on proliferating cells . It is used, for example, to treat actinic keratosis and superficial basal cell carcinoma of the skin, surface squamous neoplasia of the eye, and cervical intraepithelial neoplasm in gynecology . In the nose and sinus, topical 5‐FU has been used after the resection of ethmoidal adenocarcinoma in some centers .…”

Section: Introductionmentioning

confidence: 99%

Challenges in the Management of Inverted Papilloma: A Review of 72 Revision Cases

et al. 2015

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“…5-FU is pyrimidine analogue cytotoxic agent used in the treatment of cancer and topical application of a 5% solution of this drug for 8 weeks over a 16 week period has been used to treat CIN2 31 . This produced regression of disease in 96% of patients after 6 months follow up although only 50% had normal pathology and were also negative for HPV.…”

Section: -Flurouracil (5-fu)mentioning

confidence: 99%

An overview of early investigational drugs for the treatment of human papilloma virus infection and associated dysplasia

Hampson

Martin-Hirsch

Hampson

2015

Expert Opinion on Investigational Drugs

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Introduction: Infection with hHigh-risk types of HPV (HR-HPV) isare the main aetiological agent forcause of invasive cervical cancer (ICC) from which there are >270,000 deaths per annum world-wide with over 85% of these occurring in lowresource countries. Ablative and excisional treatment modalities are restricted for use with high-grade pre-cancerous cervical disease with HPV infection and low-grade dysplasia is currently managed by a watch-and-wait policy.

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Topical 5-fluorouracil for treatment of cervical intraepithelial neoplasia 2: a randomized controlled trial

Cited by 52 publications

References 20 publications

Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis

Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis

Challenges in the Management of Inverted Papilloma: A Review of 72 Revision Cases

An overview of early investigational drugs for the treatment of human papilloma virus infection and associated dysplasia

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