Focused Ultrasound versus the Loop Electrosurgical Excision Procedure to Treat Women with Cervical High-grade Squamous Intraepithelial Lesions Under 40: A Retrospective Study

Abstract

Abstract Background To evaluate whether focused ultrasound (FUS) or the loop electrosurgical excision procedure (LEEP) is a more feasible treatment for cervical high-grade squamous intraepithelial lesions (HSILs) among women of reproductive age. Methods Retrospective case record review of patients under 40 years treated for cervical HSIL using either FUS or LEEP from 1 September 2020 to 31 May 2022. Patients were followed up for cure, recurrence, human papillomavirus (HPV) clearance, and complications within 1 year following treatment. Odds ratios and 95% confidence intervals for no evidence of disease or HPV clearance associated with the treatment modalities and other covariates were estimated using univariate and multivariate logistic regression models. Results Among 1054 women who underwent FUS or LEEP, 225 met our selection criteria, of which 101 and 124 received FUS and LEEP, respectively. No significant difference was found in the cure rate during the 3–6-months follow-up (89.11% vs. 94.35%, P = 0.085), nor was there any such difference in the recurrence rate during the 6–12-months follow-up (2.22% vs. 1.71%, P = 0.790) between the two therapies. Both groups showed increasing cumulative HPV clearance rates over time without statistically significant differences (74.23% vs. 82.79%; P = 0.122, during the 3–6-months follow-up, and 84.95% vs. 89.17%; P = 0.359, during the 6–12-months follow-up). Furthermore, the incidence of complications caused by the two techniques was found to be similar. (5.0% vs. 5.6%, P = 0.818). Conclusion We found a similarity in effectiveness, safety and reliability between FUS and LEEP in treating women with HSIL under 40.