Clinical predictors in the natural history of uterine leiomyoma: preliminary study.

Tsuda, Hiroshi; Kawabata, Masami; Nakamoto, Osamu; Yamamoto, Kumio

doi:10.7863/jum.1998.17.1.17

Cited by 36 publications

(33 citation statements)

References 9 publications

(6 reference statements)

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“…Studies should attempt to determine the extent to which patient characteristics, ultrasonographic features, and physiologic measures are related to UL progression from clinical diagnosis to surgical therapy, particularly hysterectomy. For example, one study suggested that increased tumor vascularity, as measured by Doppler ultrasonography, is strongly associated with increased tumor growth [224]. Similar studies, augmented by analyses of molecular features of excised UL, may help define predictors of recurrence risk following myomectomy.…”

Section: Summary and Directions For Future Researchmentioning

confidence: 99%

Epidemiology of Uterine Fibroids

Wise

Laughlin-Tommaso

2016

Clinical Obstetrics &Amp; Gynecology

246

122

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Uterine leiomyomata (UL) have a substantial impact on women's health, but relatively few studies have identified opportunities for primary prevention of these neoplasms. Most established risk factors are not modifiable, including premenopausal age, African ancestry, age at menarche, and childbearing history. The main challenge in studying UL is that a large proportion of tumors are asymptomatic. Herein, we review the epidemiology of UL from published studies to date. We highlight the advantages of ultrasound screening studies and the ways in which their innovative methods have helped clarify the etiology of disease. We conclude with a discussion of promising new hypotheses.

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Section: Summary and Directions For Future Researchmentioning

confidence: 99%

Epidemiology of Uterine Fibroids

Wise

Laughlin-Tommaso

2016

Clinical Obstetrics &Amp; Gynecology

246

122

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“…1 Aetiologies of uterine leiomyomas are unknown but several predisposing factors have been identified including age (late reproductive years), African-American ethnicity, nulliparity, obesity and genetics. 2 It is seven times commoner in blacks compared to Caucasians 3 and can grow so large to cause negative impact on obstetric outcome if co-existing with pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Sonographic assessment of pregnancy co-existing with uterine leiomyoma in Owerri, Nigeria

Eze¹,

Odumeru²,

Ochie³

et al. 2013

Afr H. Sci.

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Background: Uterine myomas co-existing with pregnancy could cause obstetric complications. Objectives: To assess sonographically the frequency of occurrence and effect of uterine myomas co-existing with pregnancy. Methods: A longitudinal study was conducted during a period of 23 months. A convenience sample of 816 consecutive consenting pregnant women who met the inclusion criteria was evaluated during routine prenatal ultrasound scan. The women were referred for prenatal sonography. One hundred of the subjects who had myoma co-existing with pregnancy and another 100 subjects without myoma were selected for follow-up. These groups were followed up till delivery and obstetric complications and outcomes were documented. Any changes in size and growth rate of myoma were documented. Results: Subjects with myoma co-existing with pregnancy were 12.3%. This was commoner with increasing maternal age. An increase was observed in myoma mean size from 60mm to 63mm from the 1 st scan sequence to the 2 nd scan sequence and a reduction from 63mm to 59mm in the 3 rd scan sequence. Myoma growth rate was 0.667mm per week. Myomas in pregnancy especially large ones caused more complications during delivery when compared to pregnancies without myomas. Conclusion: Routine sonography is important in pregnancy management of uterine myomas co-existing with pregnancy.

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“…Symptoms increase with the size of fibroids (7,9,10). However, few studies have examined the growth of fibroids over time (11)(12)(13), and no study has systematically followed the growth of fibroids in black and white women.…”

mentioning

confidence: 99%

Growth of uterine leiomyomata among premenopausal black and white women

Peddada

Laughlin

Miner

et al. 2008

Proc. Natl. Acad. Sci. U.S.A.

307

227

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Uterine leiomyomata (fibroids) are the leading cause of hysterectomy in the United States. Black women have a greater fibroid burden than whites, yet no study has systematically evaluated the growth of fibroids in blacks and whites. We prospectively tracked growth for 262 fibroids (size range: 1-13 cm in diameter) from 72 premenopausal participants (38 blacks and 34 whites). Fibroid volume was measured by computerized analysis of up to four MRI scans over 12 months. We used mixed effects models to identify factors that are associated with growth, and results were converted to percent change per 6 months for clinical relevance. The median growth rate was 9% (range: ؊89% to ؉138%). Seven percent of fibroids regressed (>20% shrinkage). Tumors from the same woman grew at different rates (within-woman component of variation was twice the component among women; both were significant, P < 0.001). Black and white women less than 35 years of age had similar fibroid growth rates. However, growth rates declined with age for whites but not for blacks (P ‫؍‬ 0.05). The odds of a tumor growing more than 20% in 6 months also decreased with age for whites but not for blacks (P < 0.01). Growth rates were not influenced by tumor size, location, body mass index, or parity. We conclude that (i) spontaneous regression of fibroids occurs; (ii) fibroids from the same woman grow at different rates, despite a uniform hormonal milieu; (iii) fibroid size does not predict growth rate; and (iv) age-related differences in fibroid growth between blacks and whites may contribute to the higher symptom burden for black women.ethnic ͉ fibroid ͉ MRI ͉ tumor growth ͉ longitudinal data U terine leiomyomata (fibroids) are the leading indication for hysterectomy in the United States (1). Myomectomy and uterine artery embolization are also common treatments, but hysterectomy may be required subsequently (2). Hartmann et al. (3) estimate a $4,600 excess health care cost during the year following each US woman's diagnosis of fibroids. National medical costs associated with fibroids exceed 2 billion dollars annually (4). African Americans have a higher fibroid incidence (5, 6), experience more severe symptoms (7), present with larger tumors (7), and have a threefold higher risk of hysterectomy (8) compared with whites. Symptoms increase with the size of fibroids (7, 9, 10). However, few studies have examined the growth of fibroids over time (11-13), and no study has systematically followed the growth of fibroids in black and white women.The Fibroid Growth Study was designed to measure the growth of fibroids in black and white women with clinically relevant fibroids using MRI technology. We compare growth rates of individual tumors from the same woman; contrast fibroid growth in black and white women; and examine associations with age, parity, body mass index (BMI), and tumor characteristics. ResultsStudy Participants. Characteristics of the 72 participants are shown in Table 1. Our cohort ranged in age from 24 to 54 years, and approximately half were Afri...

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Clinical predictors in the natural history of uterine leiomyoma: preliminary study.

Cited by 36 publications

References 9 publications

Epidemiology of Uterine Fibroids

Epidemiology of Uterine Fibroids

Sonographic assessment of pregnancy co-existing with uterine leiomyoma in Owerri, Nigeria

Growth of uterine leiomyomata among premenopausal black and white women

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