Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis.

IF 3 3区 医学 Q2 ONCOLOGY
International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-01-02 DOI:10.1080/02656736.2023.2299479
Yuya Dou, Lian Zhang, Yu Liu, Min He, Yanzhou Wang, Zhibiao Wang
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引用次数: 0

Abstract

Objectives: To quantify the reintervention rate and analyze the risk factors for reintervention after high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.

Methods: Eighteen studies were selected from the seven databases. A meta-analysis was applied to synthesize the reintervention rates for fibroids across various follow-up durations. Subgroup-analysis was conducted based on the year of surgery, sample size, guide methods, and non-perfusion volume ratio (NPVR). Signal intensity of T2-weighted imaging (T2WI) was independently evaluated for reintervention risk.

Results: The study enrolled 5216 patients with fibroids treated with HIFU. There were 3247, 1239, 1762, and 2535 women reaching reintervention rates of 1% (95% confidence interval (CI): 1-1), 7% (95% CI: 4-11), 19% (95% CI: 11-27), and 29% (95% CI: 14-44) at 12, 24, 36, and 60-month after HIFU. The reintervention rates of patients treated with US-guided HIFU (USgHIFU) were significantly lower than those of patients treated with MR-guided focused ultrasound surgery (MRgFUS). When the NPVR of fibroids was over 50%, the reintervention rates at 12, 36 and 60-month after HIFU were 1% (95% CI: 0.3-2), 5% (95% CI: 3-8), and 15% (95% CI: 9-20). The reintervention risk for hyper-intensity fibroids on T2WI was 3.45 times higher (95% CI: 2.7-4.39) for hypo-/iso-intensity fibroids.

Conclusion: This meta-analysis showed that the overall reintervention rates after HIFU were acceptable and provided consultative suggestions regarding treatment alternatives for patients with fibroids. Subgroup-analysis revealed that USgHIFU, NPVR ≥ 50%, and hypo-/iso-intensity of fibroids on T2WI were significant factors in reducing reintervention.

Systematic review registration: PROSPERO, CRD42023456094.

子宫肌瘤高强度聚焦超声消融术后的长期疗效和再次介入的风险因素:系统回顾和荟萃分析。
目的量化子宫肌瘤高强度聚焦超声(HIFU)消融术后的再介入率,并分析再介入的风险因素:方法:从七个数据库中筛选出 18 项研究。方法:从 7 个数据库中选取了 18 项研究,采用荟萃分析法对不同随访期的子宫肌瘤再干预率进行综合分析。根据手术年份、样本大小、引导方法和非灌注容积比(NPVR)进行了分组分析。T2加权成像(T2WI)的信号强度是再次介入风险的独立评估指标:研究共纳入了5216名接受HIFU治疗的子宫肌瘤患者。在HIFU治疗后12、24、36和60个月,分别有3247、1239、1762和2535名妇女的再干预率分别为1%(95%置信区间(CI):1-1)、7%(95% CI:4-11)、19%(95% CI:11-27)和29%(95% CI:14-44)。采用 USgHIFU 治疗的患者的再干预率明显低于采用 MRgFUS 治疗的患者。当子宫肌瘤的NPVR超过50%时,HIFU治疗后12个月、36个月和60个月的再干预率分别为1%(95% CI:0.3-2)、5%(95% CI:3-8)和15%(95% CI:9-20)。T2WI上高密度肌瘤的再干预风险是低密度/等密度肌瘤的3.45倍(95% CI:2.7-4.39):这项荟萃分析表明,HIFU术后的总体再介入率是可以接受的,并为子宫肌瘤患者提供了替代治疗的咨询建议。亚组分析显示,USgHIFU、NPVR≥50%以及T2WI上肌瘤的低强度/等强度是减少再干预的重要因素:prospero,CRD42023456094。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
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