Cherepynska Yuliya

Title: Does laser excision permit the reduction of the recurrence rate of HPV-related oral lesions? A Systematic Review

The aim of this systematic review is to evaluate the recurrence rate (RR) of human papillomavirus (HPV)-related oral lesions after the different laser excision in comparison to the scalpel excision.

We used the standard methodological procedures expected by PubMed, Web of Science, and Scopus, and used the keywords (papillomavirus OR HPV OR papilloma), laser, AND oral OR oral lesion) of retrospective literature studies. The primary outcomes were the type the excision, and its recurrence rate. Our secondary outcomes included laser wavelengths, parameters, and method of excision. The confidence interval (CI) was calculated for the percentage of the RR of the oral HPV-related lesions in an Excel file on the assumption of binomial distribution of a random variable with the probability of error p <0.05. Application of the binomial law with the definition of confidence interval accurately minimizes the error and allows an accurate display of the result of the study. Inclusion criteria are the articles accessible in the full-text form of studies published over the past five years in English. The study included the laser excision of oral HPV-related lesions; the scalpel excision was used as the control group.

The search criteria were analyzed in three retrospective studies and included 579 patients to evaluate the RR of oral HPV-related lesions after excision at the follow-up timeline considered from 14 to 18 months. The range of the RR after a surgical scalpel excision (CG, n=332) 1 – 10 %; by 10600 nm laser (G1, n=115) 1 – 18,2 %; by 1064 nm laser (G2, n=65) 0 – 2 %; by 980 nm laser (G3, n=64) 1,4 %, by 2780 nm laser (G4, n=3) 0%. The confidence interval (CI), which is required in clinical studies to evaluate the results of treatments, demonstrates no significant differences between the study groups and the control group. The laser wavelengths which are applied in these studies correspond to the infrared part of the electromagnetic spectrum, so considered it appropriate to compare the effect of lasers in general G1–G4, (n = 247) – 1.5% (CI: 0.6% – 4.2%) with a surgical scalpel CG, (n = 332) versus 2.7 % (CI: 1.5% – 6.0%).

This systematic review within the limits established by the adopted inclusion criteria demonstrates no significant differences in the choice of laser excision in comparison to the scalpel excision in the evaluation of the RR of HPV-related oral lesions based on analysis of confidence intervals.