Treatment of Uterine Myomas by Radiofrequency Thermal Ablation: A 10-Year Retrospective Cohort Study

Abstract

Patients' selection criteria, effectiveness, and safety of radiofrequency thermal ablation (RFTA) therapy for uterine myomas (UM) were assessed using a 10-year retrospective cohort study. From July 2001 to July 2011, a total of 1216 patients treated for UM were divided into 2 groups. Group A consisted of 476 premenopause patients, average age 36.5 ± 8.5 years, average number of myomas 1.7 ± 0.9, and average diameter of myomas 4.5 ± 1.5 cm, and group B consisted of 740 menopause patients, average age 48.5 ± 3.5 years, average number of myomas 2.6 ± 1.3, and average diameter of myomas 5.0 ± 2.5 cm. Average follow-up period was 36.5 ± 11.5 months. At 1, 3, 6, 12, and 24 months after RFTA, average diameters of myomas in group A were 3.8, 3.0, 2.7, 2.4, and 2.2 cm, respectively, and 47.7% (227 of 476) of patients had tumor trace at 12 months after RFTA. In group B, the results were 4.7, 3.7, 3.3, 2.3, and 2.3 cm, respectively, and 58.8% (435 of 740) of patients had tumor trace at 12 months after RFTA. Three months after treatment, myoma volumes were significantly reduced in both the groups (P < .01), and group B had higher rate of tumor trace at 12 months after RFTA than group A (P < .05). Clinical symptoms and health-related quality-of-life outcome (HRQL) were significantly improved after RFTA in both groups and the postoperative recurrence rate of UM was significantly higher in group A at 10.7% (51 of 476) than group B at 2.4% (18 of 740; P < .05). Radiofrequency thermal ablation is an excellent minimally invasive treatment for UM smaller than 5.0 cm in diameter.

Nonresective treatments for uterine fibroids: a systematic review of uterine and fibroid volume reductions

“…Galen et al [14] presented multi-center, multi-study data of patients from pilot studies of a commercial laparoscopic RFA system. Yin et al [15] split their patient group into premenopausal and menopausal cohorts. However, the definition of this was not provided and menopausal women appeared to be menstruating from the study description.…”

Ultra-structure changes and survivin expression in uterine fibroids after radiofrequency ablation

“…The effectiveness of RF ablation for treating uterine fibroids RF ablation uses a high frequency alternating current to produce biological heat, which causes tumour cell DNA damage and cell death, which was different from other modalities of thermal ablation of fibroids such as microwaves, electroporation methods [9] and high intensity focused ultrasound ablation [10]. RF ablation can effectively kill local tumour cells, and it has been successfully applied to treat liver [11], kidney and prostate tumours as well as cervical intraepithelial neoplasia, dysfunctional uterine bleeding [12], and gynaecological tumours. Recently, studies on the use of RF ablation to treat uterine fibroids have emerged.…”

Comparison between radiofrequency ablation combined with mifepristone and radiofrequency ablation for large uterine fibroids

“…In recent years, ultrasound-guided (US-guided) radiofrequency ablation (RFA) has been the focus of interest as a minimally invasive strategy for patients with symptomatic uterine fibroids. Previous studies have reported that RFA can provide symptomatic relief and significant improvement in the quality of life [2][3][4][5][6][7][8][9][10]. However, optimal patients might be those with small fibroids (diameter <5 cm or volume < 180 cm 3 ) [2][3][4][5].…”