Cochrane · systematic review · CD011837
Medical and surgical interventions for the treatment of usual‐type vulval intraepithelial neoplasia
Lawrie, TA, Nordin, A, Chakrabarti, M, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Gynaecological, Neuro-oncology and Orphan CancerAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
19
current version
GRADE rated
19
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 10.5%Low 3 · 15.8%Moderate 9 · 47.4%High 5 · 26.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings for imiquimod versus placebo
Population: women with usual‐type vulval intraepithelial neoplasia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Response to treatment at 5 to 6 months ‐ overall response Summary of findings for imiquimod vs placebo | RR 11.95 [3.21, 44.51] | 3 studies · 104 participants | High |
Response to treatment at 5 to 6 months ‐ complete response Summary of findings for imiquimod vs placebo | RR 14.4 [2.97, 69.8] | 3 studies · 104 participants | High |
Response to treatment at 12 months ‐ overall response Summary of findings for imiquimod vs placebo | RR 9.1 [2.38, 34.77] | 1 study · 47 participants | Moderate Downgraded: imprecision |
Response to treatment at 12 months ‐ complete response Summary of findings for imiquimod vs placebo | RR 18.24 [1.12, 296.41] | 1 study · 47 participants | Moderate Downgraded: imprecision |
Progression to vulval cancer at 12 months Summary of findings for imiquimod vs placebo | RR 0.48 [0.05, 4.93] | 1 study · 47 participants | Low Downgraded: imprecision |
HPV DNA persistence Summary of findings for imiquimod vs placebo | RR 0.43 [0.26, 0.72] | 1 study · 47 participants | High |
Pain ‐ any grade Summary of findings for imiquimod vs placebo | RR 3.43 [1.8, 6.52] | 1 study · 52 participants | High |
Dose reductions Summary of findings for imiquimod vs placebo | RR 7.77 [1.61, 37.36] | 2 studies · 83 participants | High |
Summary of findings for imiquimod versus cidofovir
Population: women with usual‐type vulval intraepithelial neoplasia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Response to treatment at 6 months ‐ overall response Summary of findings for imiquimod vs cidofovir | RR 0.92 [0.73, 1.18] | 1 study · 180 participants | Moderate Downgraded: imprecision |
Response to treatment at 6 months ‐ complete response Summary of findings for imiquimod vs cidofovir | RR 1 [0.73, 1.37] | 1 study · 180 participants | Moderate Downgraded: imprecision |
Pain ‐ any grade Summary of findings for imiquimod vs cidofovir | RR 1.16 [0.92, 1.47] | 1 study · 168 participants | Moderate Downgraded: imprecision |
Fatigue ‐ any grade Summary of findings for imiquimod vs cidofovir | RR 1.25 [1.02, 1.55] | 1 study · 168 participants | Moderate Downgraded: imprecision |
Headache ‐ any grade Summary of findings for imiquimod vs cidofovir | RR 1.49 [1.12, 1.98] | 1 study · 168 participants | Moderate Downgraded: imprecision |
Total serious adverse events Summary of findings for imiquimod vs cidofovir | RR 1.26 [0.88, 1.81] | 1 study · 168 participants | Moderate Downgraded: imprecision |
Treatment discontinuation Summary of findings for imiquimod vs cidofovir | RR 1.33 [0.65, 2.74] | 1 study · 176 participants | Moderate Downgraded: imprecision |
Summary of findings for surgical interventions and photodynamic therapy
Population: women with usual‐type vulval intraepithelial neoplasia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Surgical excision versus laser vaporisationor other | no estimate extracted | 1 study · 73 participants | Low |
Laser vaporisation versus CUSA | RR 1.53 [0.56, 4.15] | 1 study · 30 participants | Low Downgraded: risk of bias, imprecision |
Photodynamic therapy versus laser vaporisationand surgical excision | no estimate extracted | 1 study · 52 participants | Very low Downgraded: risk of bias, imprecision |
LEEP versus laser vaporisation and surgical excision | no estimate extracted | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision |