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J Minim Invasive Gynecol · Sep 2014
Multicenter StudyThree-year outcome of the Halt trial: a prospective analysis of radiofrequency volumetric thermal ablation of myomas.
- Jay M Berman, Richard S Guido, José Gerardo Garza Leal, Rodolfo Robles Pemueller, Fredrick S Whaley, Scott G Chudnoff, and Halt Study Group.
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan. Electronic address: jberman@med.wayne.edu.
- J Minim Invasive Gynecol. 2014 Sep 1; 21 (5): 767-74.
Study ObjectiveTo analyze the clinical success of radiofrequency volumetric thermal ablation (RFVTA) at 3-year follow-up in terms of subject responses to validated questionnaires and surgical repeat intervention to treat myomas.DesignProspective follow-up of patients for 36 months after treatment in a multicenter international trial of outpatient, laparoscopic ultrasound-guided RFVTA of symptomatic uterine myomas (Canadian Task Force classification II-1).SettingUniversity hospitals and private surgical centers.PatientsOne hundred thirty-five premenopausal women (mean [SD] age, 42.5 [4.6] years; body mass index, 30.5 [6.1]) with symptomatic uterine myomas and objectively confirmed heavy menstrual bleeding (≥ 160 to ≤ 500 mL).InterventionsLaparoscopic ultrasound-guided RFVTA.Measurements And Main ResultsOne hundred four participants were followed prospectively for 36 months after treatment of myomas via RFVTA. For 104 evaluable participants with 36-month data, change in mean (SD) symptom severity from baseline (60.2 [18.8]) to 36 months was -32.6 (95% confidence interval, -37.5 to -27.8; p < .001). Health-related quality of life also was improved, from the baseline value of 39.2 (19.2) to 38.6 (95% confidence interval, 33.3 to 43.9; p < .001) at 36 months. Patient-reported Uterine Fibroid Symptom and Health-Related Quality of Life questionnaire subscores demonstrated statistically significant improvement from baseline to 36 months in all categories (Concern, Activities, Energy/Mood, Control, Self-consciousness, and Sexual Function) (p < .001). For the 104 participants with 36-month data, mean state of health scores (EuroQOL-5D Health State Index) improved from a baseline value of 71.0 (19.3) to 86.2 (11.7) at 36 months. The cumulative repeat intervention rate of 11% (14 of 135 participants) at 36 months was well below the possible 25% maximum expected at the beginning of the trial.ConclusionRFVTA of uterine myomas resulted in sustained relief from myoma symptoms and continued improvement in health-related quality of life through 36 months after ablation. The low repeat intervention data through 36 months is a positive outcome for patient well-being.Copyright © 2014. Published by Elsevier Inc.
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