5-Flouorouracil Is an Attractive Medical Treatment in Women With Vaginal Intraepithelial Neoplasia: A Meta-Analysis.
J Low Genit Tract Dis
; 22(4): 375-381, 2018 Oct.
Article
in En
| MEDLINE
| ID: mdl-30132763
ABSTRACT
OBJECTIVE:
In the absence of standard guidelines, the management of vaginal intraepithelial neoplasia (VaIN) remains a field of debate. The aim of this systematic review and meta-analysis was to ascertain the 5-flouorouracil (5-FU) effectiveness in this context. MATERIALS ANDMETHODS:
A literature search was conducted throughout the PubMed, EMBASE, SCOPUS, ClinicalTrials.gov, and Cochrane Databases for relevant studies. We computed the summary proportions of women treated for VaIN with 5-FU for the outcomes of complete response and recurrence by random-effects meta-analysis. We also performed a subgroup analysis by computing the summary proportions for complete response among women with high-grade VaIN, persistent disease, and recurrence respectively.RESULTS:
Fourteen observational studies reporting on 358 women included in the study. The study quality was moderate. The summary proportions of women who had complete response after the first 5-FU course were 82.18% (95% CI = 69.80%-88.82%). The summary proportions of women who recurred were 16.42% (95% CI = 7.39%-28.14%). The summary proportions of women with complete response in the high-grade VaIN, persistent disease, and recurrence subgroups were 77.53% (95% CI = 59.90%-91.15%), 53.92% (95% CI = 34.62%-72.61%), and 72.32% (95% CI = 48.12%-91.05%), respectively.CONCLUSIONS:
This is the first meta-analysis to date to provide a convincing overview of 5-FU efficacy on the VaIN treatment. Albeit a medium risk of bias warrants some caution with interpretation of the results, 5-FU can be an attractive alternative to surgery, especially among young women with multifocal and recurrent disease.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vaginal Neoplasms
/
Carcinoma in Situ
/
Fluorouracil
/
Antineoplastic Agents
Type of study:
Guideline
/
Observational_studies
/
Systematic_reviews
Limits:
Female
/
Humans
Language:
En
Journal:
J Low Genit Tract Dis
Journal subject:
GINECOLOGIA
Year:
2018
Document type:
Article
Affiliation country: