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Uterine fibroids registry looks to provide comparative treatment.


EARLY FINDINGS from a uterine fibroids registry suggest more than half of enrolled women chose an alternative to hysterectomy, underscoring the need to study the efficacy of these uterine-sparing treatment options, said Elizabeth A. Stewart, MD, of the Mayo Clinic, Rochester, Minn., and her associates.

There is very little evidence on the comparative efficacy of uterine fibroid treatment options so the COMPARE-UF (Comparing Options for Management: Patient-Centered Results for Uterine Fibroids) registry was initiated for women who choose procedural therapy for symptomatic uterine fibroids. Data at the nine clinical centers--representing rural and urban populations--are being collected regarding hysterectomy, myomectomy (abdominal, hysteroscopic, vaginal, and laparoscopic/robotic), endometrial ablation, radio-frequency fibroid ablation, uterine artery embolization, magnetic resonance-guided focused ultrasound, and therapeutic use of progestin-releasing intrauterine devices.

Of the initial 2,031 women enrolled, hysterectomy was chosen by 38%. Myomectomies were chosen by 46% of women; laparoscopic or robotic myomectomies were picked most frequently, accounting for 19% of all procedures. Of the other procedures, 7% chose endometrial ablation, 6% chose uterine artery embolization, less than 1% chose radiofrequency fibroid ablation or magnetic resonance-guided focused ultrasound, and none chose IUD.

A total of 16% of the women were under age 35, and 40% were aged 40 years or younger. "The fact that a sizable proportion of women are under age 40 suggests that with long-term follow-up, data on reproductive outcomes can be obtained as these women seek pregnancy," Dr. Stewart and her associates noted.

African American women chose similar or greater numbers of each type of myomectomy and uterine embolization as white women chose.

The study was supported by a grant from the Agency for Healthcare Research and Quality. Dr. Stewart reported personal fees from Abb Vie and several other companies.

SOURCE: Stewart EA et al. Am J Obstet Gynecol. 2018 May. doi: 10.1016/j. ajog.2018.05.004.

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Author:Nellist, Catherine Cooper
Publication:OB GYN News
Date:Jul 1, 2018
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