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- Title
A Comparative Analysis of Health-Related Quality of Life 1 Year Following Myomectomy or Uterine Artery Embolization: Findings from the COMPARE-UF Registry.
- Authors
Anchan, Raymond M.; Wojdyla, Daniel; Bortoletto, Pietro; Terry, Kathryn; Disler, Emily; Milne, Ankrish; Gargiulo, Antonio; Petrozza, John; Brook, Olga; Srouji, Serene; Morton, Cynthia C.; Greenberg, James; Wegienka, Ganesa; Stewart, Elizabeth A.; Nicholson, Wanda K.; Thomas, Laine; Venable, Sateria; Laughlin-Tommaso, Shannon; Diamond, Michael P.; Maxwell, G. Larry
- Abstract
Objective: To compare 12-month post-treatment health-related quality of life (HR-QoL) and symptom severity (SS) changes among patients with symptomatic uterine fibroids (SUF) not seeking fertility and undergo a hysterectomy, abdominal myomectomy (AM), or uterine artery embolization (UAE). Materials and Methods: The Comparing Options for Management: Patient-Centered Results for Uterine Fibroids (COMPARE-UF) Registry is a multi-institutional prospective observational cohort study of patients treated for SUF. A subset of 1465 women 31–45 years of age, who underwent either hysterectomy (n = 741), AM (n = 446), or UAE (n = 155) were included in this analysis. Demographics, fibroid history, and symptoms were obtained by baseline questionnaires and at 1 year post-treatment. Results were stratified by all treatments and propensity score weighting to adjust for differences in baseline characteristics. Results: Women undergoing UAE reported the lowest baseline HR-QoL and highest SS scores (mean = 40.6 [standard deviation (SD) = 23.8]; 62.3 [SD = 24.2]) followed by hysterectomy (44.3 [24.3]; 59.8 [SD = 24.1]). At 12 months, women who underwent a hysterectomy experienced the largest change in both HR-QoL (48.7 [26.2]) and SS (51.9 [25.6]) followed by other uterine-sparing treatments. Propensity score weighting revealed all treatments produced substantial improvement, with hysterectomy patients reporting the highest HR-QoL score (92.0 [17.8]) compared with myomectomy (86.7 [17.2]) and UAE (82.6 [21.5]) (p < 0.0001). Similarly, hysterectomy patients reported the lowest SS scores (8.2 [15.1]) compared with myomectomy (16.5 [15.1]) and UAE (19.6 [17.5]) (p < 0.0001). Conclusion: All procedures showed improvement in HR-QoL and reduction in SS score at 12 months, hysterectomy showing maximum improvement. Of importance, at 12 months, patients who underwent either a myomectomy or UAE reported comparable symptom relief and HR-QoL. Clinicaltrials.Gov Identifier: NCT02260752.
- Subjects
SCIENTIFIC observation; HYSTERECTOMY; UTERINE fibroids; THERAPEUTIC embolization; TREATMENT effectiveness; COMPARATIVE studies; QUALITY of life; RESEARCH funding; DESCRIPTIVE statistics; UTERINE artery; LONGITUDINAL method
- Publication
Journal of Women's Health (15409996), 2023, Vol 32, Issue 4, p423
- ISSN
1540-9996
- Publication type
Article
- DOI
10.1089/jwh.2022.0133