title: Value-based medicine analysis on loop electrosurgical excision procedure and CO2 laser vaporization for the treatment of cervical intraepithelial neoplasia 2.
abstract: OBJECTIVE
  The best treatment option for cervical intraepithelial neoplasia 2 (CIN2) is controversial and there is a lack of studies in value-based medicine. This multicenter comparative study was undertaken to evaluate the effectiveness, cost-effectives and quality of life (QOL) of loop electrosurgical excision procedure (LEEP) and CO(2) laser vaporization for the treatment of CIN2.
  
  
  METHODS
  A database of LEEP and laser vaporizations performed at three research centers was created. Patients with colposcopic-histopathologically confirmed CIN2 were randomly submitted to LEEP and laser vaporization. Cytology, human papilloma virus (HPV) DNA test and histology were performed, and a questionnaire on QOL was filled out during follow-up. Effectiveness, cost-effectives and QOL were analyzed.
  
  
  RESULTS
  Three hundred and thirty-eight women with CIN2 were included in the study. Frequencies of remission, and persistent and recurrent CIN were 89.2%, 7.2%, and 3.6% for LEEP, and 86.7%, 12.6%, 0.70% for laser, respectively. There was no significant difference in remission and persistence of CIN. There was a significant difference in the number of operations, recovery time and costs. Women treated with two methods showed relatively identical QOL.
  
  
  CONCLUSIONS
  Both LEEP and CO(2) laser vaporization are effective and reliable treatments for CIN2, whereas cervical tissue can be obtained for histology by LEEP. Preoperative evaluation and postoperative follow-up are important. Gynecologists should pay attention to QOL of patients with CIN.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College/Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Lu-lu
authors.initials: LL
authors.lastname: Sun
authors.forename: Dong-yan
authors.initials: DY
authors.lastname: Cao
authors.forename: Jia-xin
authors.initials: JX
authors.lastname: Yang
authors.forename: Mei-lu
authors.initials: ML
authors.lastname: Bian
authors.forename: Li-hui
authors.initials: LH
authors.lastname: Wei
authors.forename: Keng
authors.initials: K
authors.lastname: Shen
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D004598:Electrosurgery / Q000009:adverse effects / Q000191:economics; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000191:economics; D054020:Lasers, Gas; D011788:Quality of Life; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000601:surgery*