Short-Term Efficacy of Trichloroacetic Acid in the Treatment of Cervical Intraepithelial Neoplasia. Issue 2 (February 2016)

• Record Type: Journal Article
• Authors: Geisler, Stephanie; Speiser, Sophie; Speiser, Lukas; Heinze, Georg; Rosenthal, Adam; Speiser, Paul
• Is Part Of: Obstetrics and gynecology. Volume 127:Issue 2(2016)
• Publication Date: 2016-02
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/AOG.0000000000001244
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : OBJECTIVE: To establish the short-term efficacy and tolerability of a single topical 85% trichloroacetic acid treatment for cervical intraepithelial neoplasia (CIN) 1–3. METHODS: A retrospective case series including all patients with CIN treated with trichloroacetic acid as first-line therapy was performed. Treatment response was evaluated by colposcopy, cervical biopsy, cytology, and type-specific human papillomavirus (HPV) testing 8 weeks after a single trichloroacetic acid treatment. Regression was defined as improvement from high-grade to low-grade CIN and remission was defined as improvement from any grade of CIN to no CIN. For quantification of treatment-related pain, 107 (44.1%) patients rated their subjective perception on a visual analog scale. RESULTS: A total of 241 women were included in the study with 179 high-grade (CIN 2–3) and 62 low-grade (CIN 1) squamous intraepithelial lesions. For high-grade squamous intraepithelial lesions, the histologic regression rate was 87.7% (95% confidence interval [CI] 82.0–92.1) and the remission rate was 80.3% (95% CI 73.3–85.5). For low-grade squamous intraepithelial lesions, the remission rate was 82.3% (95% CI 70.5–90.8). Human papillomavirus types 16 and 18 were found in 53.7% and 7.3% of all women tested, respectively. Clearance rates of HPV type 16 and HPV type 18 were 73.5% (95% CI 62.5–81.3) and 75.0% (95% CI 46.2–95.0), respectively. Median pain score was 3.0 out of 10.0 (25th and 75th percentiles 2.3 and 4.3, respectively). There were no major side effects observed during treatment or follow-up. CONCLUSION: A high regression and remission rate and a high HPV clearance rate were observed 8 weeks after topical 85% trichloroacetic acid treatment for patients with CIN. Abstract : A high regression and remission rate and a high human papillomavirus clearance rate can be observed 8 weeks after trichloroacetic acid treatment for cervical intraepithelial neoplasia.