Risk factors for recurrence in patients with uterine fibroids treated with high-intensity focused ultrasound

Background Uterine fibroids, benign smooth muscle tumors prevalent in the female genital tract, affecting up to 40% of women of childbearing age. High-intensity focused ultrasound (HIFU) has emerged as a promising non-invasive approach for treating uterine fibroids, but some patients may still experience recurrence of uterine fibroids after treatment. Objective This study aims to explore the risk factors associated with uterine fibroid recurrence following HIFU treatment, and to provide a basis for formulating response measures to prevent uterine fibroid recurrence after surgery in clinical practice. Methods In this regression observational study, 120 patients with uterine fibroids who underwent HIFU therapy at our institution from Jan 2018 to Dec 2021 were included as the study subjects. Collect clinical data of all included patients, and follow up for a total of 2 years every 6 menstrual periods with gynecological ultrasound or related examinations after surgery. Univariate and logistic regression analyses were performed to identify risk factors for recurrence in potential uterine fibroid patients receiving HIFU knife treatment. Results Patients were divided into a relapse group (n = 27) and a non-relapse group (n = 93) based on recurrence during the follow-up period. The outcome of univariate analysis indicated no statistically significant difference in age, BMI, age at menarche, history of preoperative pregnancy, history of postoperative pregnancy, family history of uterine fibroids, Bcl-2, FSH, LH, E2, PRL, P, and T between the two groups ( p > 0.05). Notably, significant differences were observed in fibroid diameter, ER, and PR ( p < 0.05). Logistic regression analysis revealed uterine fibroid diameter (OR = 28.032, 6.074 ∼ 129.372), PR (OR = 4.642, 2.382 ∼ 9.049), and ER (OR = 3.435, 1.820 ∼ 6.483) were independent risk factors for uterine fibroid recurrence after HIFU knife treatment. ROC curve analysis showed that the AUC of uterine fibroid recurrence predicted by fibroid diameter, ER, and PR after HIFU knife treatment were 0.791, 0.738, and 0.785, respectively. Conclusion The diameter, ER, and PR of uterine fibroids are closely related to the recurrence of uterine fibroids after surgical treatment, and it is worth implementing key perioperative management in clinical practice to prevent and manage the recurrence of uterine fibroids.