SynthesisPloS one2017
Comparison of Cold-Knife Conization versus Loop Electrosurgical Excision for Cervical Adenocarcinoma In Situ (ACIS): A Systematic Review and Meta-Analysis.
Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- 2023 Canadian Colposcopy Guideline: A Risk-Based Approach to Management and Surveillance of Cervical Dysplasia.Current oncology (Toronto, Ont.) · 2023Guideline
- Variation in outcome reporting in studies of fertility-sparing surgery for cervical cancer: A systematic review.BJOG : an international journal of obstetrics and gynaecology · 2023Pooled it
- Diagnosis and Management of Adenocarcinoma in Situ: A Society of Gynecologic Oncology Evidence-Based Review and Recommendations.Obstetrics and gynecology · 2020Guideline
- Long-Term Outcomes After Cervical Cold Knife Conization or Loop Electrosurgical Excision Procedure.JAMA surgery · 2026Article
- Global Comparative Review of Guidelines for Cervical Adenocarcinoma In Situ.Life (Basel, Switzerland) · 2026Review
- Intraepithelial lesions of the uterine cervix during pregnancy: reaffirming the safety of conservative management.Gynecologic oncology reports · 2025Article
- Review
- Nationwide cohort study on the risk of high-grade cervical dysplasia and carcinoma after conservative treatment or hysterectomy for adenocarcinoma in situ.International journal of cancer · 2025Article
- Article
- Residual/recurrent lesions after cold-knife conization for high-grade cervical intraepithelial neoplasia: risk factor analysis and clinical management recommendations.Frontiers in oncology · 2025Article
- Factors associated with advanced diagnosis of cervical cancer: a hospital-based retrospective study in a state of the Brazilian Legal Amazon.Ecancermedicalscience · 2025Article
- Risk factors associated with adverse outcomes after cervical conization in patients with cervical adenocarcinoma in situ.PloS one · 2025Article
- To cut or not to cut - that is the question: a comparative analysis of long-term follow-up after complete and incomplete electroconization of the cervix due to high-grade squamous intraepithelial lesion.Frontiers in oncology · 2024Article
- Elimination of reserve cells for prevention of HPV-associated cervical cancer.Virus research · 2023Review
- Predictive Factors for Residual Disease After Conization in Cervical Cancer.Annals of surgical oncology · 2021Article
- Analysis of Conization Results in Patients undergoing Hysterectomy for Uterine Adenocarcinoma.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2020Article
- [The 2019 FIGO classification for cervical carcinoma-what's new?]Der Pathologe · 2019Review
- Oncological and reproductive outcomes of adenocarcinoma in situ of the cervix managed with the loop electrosurgical excision procedure.BMC cancer · 2018Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe objective of this systematic review was to conduct a more comprehensive literature search and meta-analysis of original studies to evaluate the efficacy and safety of the loop electrosurgical excision procedure (LEEP) versus cold-knife conization (CKC) in conservative surgical treatment of cervical adenocarcinoma in situ (ACIS) for women who have not completed childbearing.
methodsSystematic searches were conducted in the PUBMED, EMBASE, Cochrane, and China National Knowledge Infrastructure (CNKI) databases to identify all potential studies involving patients with ACIS treated with LEEP versus CKC published until December 2015.
resultsEighteen retrospective studies were included in this systematic review. All the 18 included studies reported the rate of positive margins, and the results of the individual studies varied. The positive margins were 44% (267/607) after LEEP and 29% (274/952) after CKC. The pooled meta-analysis exhibited significantly different outcome (RR, 1.55; 95% CI, 1.34-1.80, P<0.00001) without significant heterogeneity (P = 0.34). The residual rate following LEEP was 9.1% (17/186) and 11% (39/350) after CKC in re-cone or hysterectomy cases. Recurrent ACIS following LEEP was reported in 10 of 142 (7.0%) cases compared to 10 of 177 (5.6%) cases following CKC. There were no significant differences in the residual rate (RR, 1.02; 95% CI, 0.60-1.72, P = 0.95) or recurrence rate (RR, 1.13; 95% CI, 0.46-2.79; P = 0.79) between the two procedures.
conclusionsThe present systematic review demonstrates that both LEEP and CKC are safe and effective for the conservative treatment of ACIS. LEEP appears to be as equally effective as CKC regarding the residual and recurrence rates. Due to the findings showing that LEEP achieves comparable oncologic outcomes with fewer obstetric complications to that of CKC, LEEP may be the preferred option in patients whose fertility preservation is important. However, further prospective studies with a larger sample size and longer follow-up periods are needed to establish the superiority of either procedure.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.