Clinical predictors of successful magnetic resonance-guided focused ultrasound (MRgFUS) for uterine leiomyoma

Journal of Therapeutic Ultrasound

Gina K Hesley²  Elizabeth A Stewart³  David A Woodrum²  Douglas Brown²  Amy L Weaver¹  Bijan J Borah⁴  Krzysztof R Gorny² 

[1] Division of Biomedical Statistics and Informatics, Mayo Clinic and Mayo Clinic College of Medicine, 200 First St, SW, Rochester, MN 55901, USA;Department of Radiology, Mayo Clinic and Mayo Clinic College of Medicine, 200 First St, SW, Rochester, MN 55901, USA;Department of Obstetrics and Gynecology, Mayo Clinic and Mayo Clinic College of Medicine, 200 First St, SW, Rochester, MN 55901, USA;Division of Health Care Policy and Research, Mayo Clinic and Mayo Clinic College of Medicine, 200 First St, SW, Rochester MN 55901, USA

关键词: Clinical predictors;    Treatment outcomes;    MRgFUS;    Magnetic resonance-guided focused ultrasound surgery;    Symptomatology;    Uterine leiomyoma;    Fibroids;   

Others  :  801435
DOI  :  10.1186/2050-5736-1-15

 received in 2013-03-06, accepted in 2013-07-31,  发布年份 2013

【 摘 要 】

Background

Magnetic resonance-guided focused ultrasound (MRgFUS) is a relatively new minimally invasive treatment, approved by the US Food and Drug Administration in 2004 for treatments of symptomatic uterine leiomyomas (fibroids). The purpose of this work is to present retrospective cohort analysis of women that underwent commercial MRgFUS treatment between 2005 and 2009 at a single center, to identify baseline patient characteristics that predict successful MRgFUS fibroid treatment. Identifying these clinical predictors of MRgFUS would be helpful to clinicians choosing the optimal patient for this treatment modality.

Methods

One hundred thirty women with symptomatic uterine leiomyomas who underwent MRgFUS were followed up with a mean length of follow up of 17.4 ± 10.3 months. The main outcome measure of the follow-up was to identify patients who required additional fibroid treatment due to continued fibroid symptoms. Additionally, patient medical history and radiological findings obtained prior to MRgFUS were reviewed, and statistical analysis was performed to identify factors associated with reduced risk of having additional fibroid treatment.

Results

Twenty-nine patients (22.3%) underwent additional fibroid treatment due to continued or recurrent fibroid symptoms during the follow up. Cumulative incidence of additional fibroid treatment was 9.7%, 29.3%, and 44.7% at 1, 2, and 3 years following MRgFUS, respectively. In multivariable Cox proportional hazard regression analyses, older age (hazard ratio (HR) 0.54 per 5-year increase in age, 95% confidence interval 0.39 to 0.76, p < 0.001), greater number of fibroids (HR 0.19 for more than three vs. one fibroid, 95% CI 0.05 to 0.67, p = 0.033), and greater fibroid volume (HR 0.70 per doubling in volume, 95% CI 0.51 to 0.96, p = 0.025) were significantly associated with less risk of having additional fibroid treatment.

Conclusions

Older age at treatment and having multiple fibroids with larger volume are associated with a lower risk of additional intervention following MRgFUS treatment for uterine fibroids.

【 授权许可】

   
2013 Gorny et al.; licensee BioMed Central Ltd.

【 图 表 】

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