Risk of persistent high-grade squamous intraepithelial lesion after electrosurgical excisional treatment with positive margins: a meta-analysis

Abstract

CONTEXT AND OBJECTIVE: Even if precursor lesions of cervical cancer are properly treated, there is a risk of persistence or recurrence. The aim here was to quantify the risks of persistence of high-grade intraepithelial squamous lesions, one and two years after cervical electrosurgical excisional treatment with positive margins. CONCLUSÃO: Esta metanálise confirma a importância de margem comprometida como indicador de tratamento incompleto no primeiro ano e ressalta a necessidade de uma adequada escolha da técnica eletrocirúr-gica em função da localização e extensão da doença e um acompanhamento adequado dessas pacientes.

Methodological quality of systematic reviews and clinical trials on women's health published in a Brazilian evidence-based health journal

“…All SRs were on gynecological topics: teriparatide for osteoporosis in post-menopausal women (10), lapatinib for advanced or metastasized breast cancer (11), comparative evaluation of digital mammography and film mammography (12), colposcopic triage methods for grade 3 cervical intraepithelial neoplasia (CIN3) after a cytopathological diagnosis of a low-grade squamous intraepithelial lesion (13) and risk of persistent high-grade squamous intraepithelial lesion after an electrosurgical excision with positive margins (14). Three of the reviews focused on treatment (10,11,14), and two focused on diagnosis (12,13). Three of these SRs presented meta-analyses of their results (10,13,14).…”

“…Three of the reviews focused on treatment (10,11,14), and two focused on diagnosis (12,13). Three of these SRs presented meta-analyses of their results (10,13,14). …”

“…This treatment choice should be individualized for each case. The authors also recommended that additional studies were needed to determine the best strategy for following up these patients, particularly during the first year after excision (14). …”

“…Only two SRs assessed the quality of included CTs: Riera et al (11) used the Cochrane risk of bias table (9), and Iared et al (12) used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool (18). Finally, only two SRs used an appropriate method to combine studies (12,14). …”

“…The lack of a list with excluded studies could be due in part to editorial policies and the need to limit the number of words per article. Only two SRs used appropriate methods to combine studies (12,14). However, it should be noted that the other three SRs were graded as “zero” because it was impossible to perform meta-analyses due to a lack of similar studies.…”