Fig 1.
Flow chart of literature selection and network plot of included EMPD treatments.
a: Flow chart of the literature selecting process. b: The overall network of EMPD treatments documented by the included studies. Numbers indicate the number of comparative studies of corresponding treatments. Abbreviations: WLE = Wide local excision, LE = Local excision, MMS = Mohs micrographic surgery, RT = Radiotherapy, RV = Radical vulvectomy, PDT = Photodynamic therapy, LS = lasers.
Table 1.
Characters of included studies.
Fig 2.
Forest plot and SUCRA score rank of included EMPD treatments concerning their recurrence-prevention abilities.
a: Forest plot for recurrence odds ratio of included EMPD treatments (WLE was set as reference treatment). Treatments marked by asterisk show significant difference. b: SUCRA score rank of recurrence-prevention abilities of included EMPD treatments, higher scores indicate better performance on recurrence prevention. Abbreviations: WLE = Wide local excision, LE = Local excision, MMS = Mohs micrographic surgery, RT = Radiotherapy, RV = Radical vulvectomy, PDT = Photodynamic therapy, LS = lasers, CrI = Credible interval, SUCRA = Surface under the cumulative ranking.
Fig 3.
Plot for ratio of variance and DIC score changes.
a: The radio of variance contributed by individual studies. Red dots indicate the studies with higher radio than the average level. The unlisted studies were set as initial subset for forward search algorithm according to the instruction of NMAoutlier. b: The DIC scores before and after outlier removal. Abbreviations: DIC = Deviance information criteria.
Fig 4.
Forest plot and SUCRA score rank of included EMPD treatments after the outlier studies removed.
a: Forest plot for recurrence odds ratio of included EMPD treatments (WLE was set as reference treatment). Treatments marked by asterisk show significant difference. b: SUCRA score rank of recurrence-prevention abilities of included EMPD treatments, higher scores indicate better performance on recurrence prevention. Abbreviations: WLE = Wide local excision, LE = Local excision, MMS = Mohs micrographic surgery, RT = Radiotherapy, RV = Radical vulvectomy, PDT = Photodynamic therapy, LS = lasers, CrI = Credible interval, SUCRA = Surface under the cumulative ranking.
Fig 5.
Subgroup analysis of follow-up length influence on EMPD recurrence.
a: Forest plot for recurrence odds ratio of included EMPD treatments with follow-up time ˂ 60 months. b: Forest plot for recurrence odds ratio of included EMPD treatments with follow-up time ≥ 60 months. WLE was set as reference treatment, and treatments marked by asterisk show significant difference. Abbreviations: WLE = Wide local excision, LE = Local excision, MMS = Mohs micrographic surgery, RT = Radiotherapy, RV = Radical vulvectomy, PDT = Photodynamic therapy, LS = lasers, CrI = Credible interval.
Fig 6.
Subgroup analysis of the influence of different gender on EMPD recurrence.
a: Forest plot for recurrence odds ratio of EMPD treatments for male patients. b: Forest plot for recurrence odds ratio of EMPD treatments for female patients. WLE was set as the reference treatment, RV was not included as it is solely applied for women. Treatments marked by asterisk show significant difference. Abbreviations: WLE = Wide local excision, LE = Local excision, MMS = Mohs micrographic surgery, RT = Radiotherapy, RV = Radical vulvectomy, PDT = Photodynamic therapy, LS = lasers, CrI = Credible interval.
Fig 7.
Subgroup analysis of the influence of different lesion locations on EMPD recurrence.
a: Forest plot for recurrence odds ratio of EMPD treatments for genital lesions. b: Forest plot for recurrence odds ratio of EMPD treatments for perianal lesions. WLE was set as the reference treatment. Treatments marked by asterisk show significant difference. Abbreviations: WLE = Wide local excision, LE = Local excision, MMS = Mohs micrographic surgery, RT = Radiotherapy, RV = Radical vulvectomy, PDT = Photodynamic therapy, LS = lasers, CrI = Credible interval.
Fig 8.
Comparison-adjusted funnel plot.
Abbreviations: WLE ‐ Wide local excision, LE = Local excision, MMS = Mohs micrographic surgery, RT = Radiotherapy, RV = Radical vulvectomy, PDT = Photodynamic therapy, LS = lasers, CrI = Credible interval.