Evidence map›Paper›PMID 40627062›Full record

ArticleArchives of gynecology and obstetrics2025

The treatment of cervical intraepithelial neoplasia grade 2 (HSIL): between active surveillance and surgery-a 10-year monocentric data analysis.

Ulrike Ehlers, Lars Hoischen, Jan Lennart Stalp, Jens Hachenberg, Dhanya Ramachandran, Bianca Brüning, Matthias Jentschke, Peter Hillemanns, Agnieszka Denecke

Abstract read
In one paragraph

Article in Archives of gynecology and obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ulrike Ehlers *Department of Obstetrics and Gynecology, Hannover Medical School, Hanover, Germany.
Lars Hoischen *Department of Obstetrics and Gynecology, Hannover Medical School, Hanover, Germany.
Jan Lennart StalpDepartment of Obstetrics and Gynecology, Hannover Medical School, Hanover, Germany.
Jens HachenbergDepartment of Obstetrics and Gynecology, Hannover Medical School, Hanover, Germany.
Dhanya RamachandranDepartment of Obstetrics and Gynecology, Hannover Medical School, Hanover, Germany.
Bianca BrüningDepartment of Sociology, Leibniz University, Hannover, Germany.
Matthias JentschkeDepartment of Obstetrics and Gynecology, Hannover Medical School, Hanover, Germany.
Peter HillemannsDepartment of Obstetrics and Gynecology, Hannover Medical School, Hanover, Germany.
Agnieszka DeneckeDepartment of Obstetrics and Gynecology, Hannover Medical School, Hanover, Germany. denecke.agnieszka@mh-hannover.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn recent years, active surveillance has been introduced as an alternative to excisional treatment in younger women with cervical intraepithelial neoplasia grade 2 (CIN 2) because spontaneous regression rate is high and excisional treatment is associated with an increased risk of preterm birth. However, the potential effect of this conservative approach on the risk of developing cervical cancer has not been evaluated very well.

methodsThe present study offers a real-life analysis of treatment pathways for patients diagnosed with CIN 2.

resultsFollowing CIN 2 diagnosis, 84 cases out of 187 (44.9%) were managed conservatively for at least 7 months and 103 cases (55.1%) were admitted for an excisional procedure LEEP (loop electrosurgical excision procedure). Out of 84 patients observed with a CIN 2 diagnosis, 64 showed persistence of CIN 2 lesion (76.2%), 14 showed spontaneous remission under active surveillance (16.7%), 4 progressed to CIN 3 (4.8%) and 2 to carcinoma (one case of vaginal carcinoma and one case of cervical adenocarcinoma (Supplementary Fig. 1) (2.4%). We observed the regression of CIN 2 in 16.7% of patients on active surveillance and this was statistically significant during the observation period (95% CI 5.72-10.85, p < 0.001) (Supplementary Fig. 3).

conclusionThe choice of treatment was strongly associated with HPV typing in our study. Patients with HPV 16 infection underwent surgery more often than patients without HPV 16 infection. The difference in our study was statistically significant (p < 0.001). We observed regression of CIN 2 in 16.7% of patients on active surveillance and this was statistically significant to the observation period (95% CI 5.72-10.85, p < 0.001).

Indexed as

Uterine Cervical DysplasiaUterine Cervical NeoplasmsWatchful WaitingAdultDisease ProgressionElectrosurgeryFemaleHumansMiddle AgedRetrospective StudiesYoung AdultCIN 2HPV InfectionTreatment

Identifiers

PMID40627062
PMCPMC12414026

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