Nonresective treatments for uterine fibroids: a systematic review of uterine and fibroid volume reductions
File(s)
Published version
Author(s)
Taheri, Melody
Galo, Laura
Potts, Callum
Sakhel, Khaled
Quinn, Stephen Derek
Type
Journal Article
Abstract
Patients are increasingly seeking uterus-preserving, minimally invasive treatments for symptomatic uterine fibroids. This has led to a greater use of nonresective treatments such as uterine artery embolization (UAE), focused ultrasound (FUS) and more recently, radiofrequency ablation (RFA) of fibroids. This systematic review, following PRISMA guidelines, examines the change in uterine and fibroid volumes associated with UAE, FUS, and RFA. Pubmed and MedlinePlus databases were searched from 1956 to 2016. The keywords used were ‘radiofrequency ablation,’ ‘magnetic resonance guided focused ultrasound,’ ‘ultrasound guided focused ultrasound’, ‘uterine artery embolization,’ ‘uterine fibroid embolization,’ and ‘leiomyoma’ or ‘fibroid’. Publications with at least 20 patients were included. Data were collected and analyzed using Microsoft Excel® (Microsoft Corporation, Redmond, WA) software. Eighty-one relevant papers were identified: 52 related to UAE, 11 to RFA, 17 to FUS, 1 compared UAE and FUS. We report the published uterine volume and fibroid volume changes seen in these studies at 1 to 36 months. The pooled fibroid volume reductions at six months seen with RFA were 70%, UAE 54% and FUS 32%. All three types of nonresective treatment result in fibroid volume reduction. However, fibroid volume reduction is most marked with RFA, with UAE resulting in the next most volume reduction. Additional larger cohort studies, including those that are randomized and/or comparative, would enable definitive conclusions. This is the first systematic review comparing uterine and fibroid volume reduction after RFA, UAE and MRgFUS.
Date Issued
2019-01-01
Date Acceptance
2018-12-27
Citation
International Journal of Hyperthermia, 2019, 36 (1), pp.295-301
ISSN
0265-6736
Publisher
Informa UK Limited
Start Page
295
End Page
301
Journal / Book Title
International Journal of Hyperthermia
Volume
36
Issue
1
Copyright Statement
© 2019 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Subjects
1103 Clinical Sciences
Oncology & Carcinogenesis
Publication Status
Published
Date Publish Online
2019-01-24