The Fibroid Growth Study: Determinants of Therapeutic Intervention
The Fibroid Growth Study: Determinants of Therapeutic Intervention
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DOI：
10.1089/jwh.2008.0903
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发表时间：
2009-05-01
影响因子：
3.5
通讯作者：
Baird, Donna Day
中科院分区：
文献类型：
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作者：
Davis, Barbara J.;Haneke, Karen E.;Baird, Donna Day
目标：对一项研究的参与者的人口统计学、种族、症状、生活方式特征和治疗结果进行分析，该研究旨在评估子宫肌瘤的生长，并将临床相关女性人群的症状和结果相关联（纤维瘤生长研究）。纳入纤维瘤生长研究（FGS）的妇女完成了病史和体格检查，进行T1加权和T2加权磁共振成像（MRI）扫描，在每次计划的MRI时提供尿液和血液样本，并回答最初的广泛电话问卷，然后每月更新简短的问卷。开发了汇总评分以量化应激、疼痛和出血。Wilcoxin检验用于研究参与者特征和肿瘤相关特征之间的统计学比较。结果：参与者包括116名绝经前妇女，年龄从20岁到54岁不等; 48%是黑人妇女，41%是白色妇女，10%是其他或多个种族背景的妇女，1%没有自我认同。超过90%的参与者患有多发性平滑肌瘤，近三分之一患有10个以上。黑人妇女更年轻，有更多的肌瘤，但没有发现差异的比例，黑人和白色妇女选择干预措施; 44%的黑人妇女和40%的白色妇女选择干预在study.Conclusions：没有相关性之间的平滑肌瘤或子宫大小和选择治疗。然而，与没有干预的女性相比，选择治疗的女性症状更明显，出血和疼痛评分更高。因此，我们的研究表明，一旦女性出现症状，黑人和白色女性选择手术作为治疗方法的原因相同，比例大致相同。此外，我们的数据表明，出血和疼痛，而不是肌瘤的大小或多样性，决定了干预的选择。因此，积极管理疼痛和出血可能有效地减少手术干预的需要。
Aims: The demographics, ethnicity, symptoms, lifestyle characteristics, and treatment outcomes are analyzed in participants of a study designed to evaluate uterine leiomyoma growth and correlate symptoms and outcomes in a clinically relevant population of women (Fibroid Growth Study).Methods: Women included in the Fibroid Growth Study (FGS) completed a medical history and physical examination, underwent T1-weighted and T2-weighted magnetic resonance image (MRI) scans, provided urine and blood samples at each scheduled MRI, and responded to an initial extensive telephone-administered questionnaire followed by abbreviated monthly questionnaire updates. Summary scores were developed to quantify stress, pain, and bleeding. The Wilcoxin test was used for statistical comparisons between study participant characteristics and tumor-related characteristics.Results: Participants included 116 premenopausal women, ranging in age from 20 to 54 years; 48% were black women, 41% were white women, 10% were women of other or multiple racial backgrounds, and 1% did not self-identify. Over 90% of participants had multiple leiomyomas, and nearly a third had more than 10. Black women were younger and had more fibroids, but no differences were found in the proportions of black and white women choosing an intervention; 44% of black women and 40% of white women chose intervention during the study.Conclusions: There was no correlation between number of leiomyomas or uterine size and choosing treatment. However, women who opted for treatment were more symptomatic, with higher bleeding and pain scores, compared with the women with no intervention. Consequently, our study suggests that once women are symptomatic, black and white women choose surgery as a treatment method for the same reasons and at about the same rates. Moreover, our data suggest that bleeding and pain, not the size or multiplicity of fibroids, determine the choice for intervention. Therefore, aggressive management of pain and bleeding may be effective in reducing the need for surgical intervention.