Trial reportAmerican journal of obstetrics and gynecology2019
FIRSTT study: randomized controlled trial of uterine artery embolization vs focused ultrasound surgery.
Trial report in American journal of obstetrics and gynecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00995878 (The FIRSTT Study), which is not on this map. Cited by 28 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The FIRSTT Study: Comparing Focused Ultrasound and Uterine Artery Embolization for Uterine Fibroids
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Evaluating treatment options for symptomatic uterine fibroids: a systematic review and meta-analysis of effectiveness, recovery, and long-term outcomes (MARIE WP1).Frontiers in global women's health · 2025Pooled it
- The impact of fibroid treatments on quality of life and mental health: a systematic review.Fertility and sterility · 2024Pooled it
- A Systematic Review of Minimally Invasive Approaches to Uterine Fibroid Treatment for Improving Quality of Life and Fibroid-Associated Symptoms.Reproductive sciences (Thousand Oaks, Calif.) · 2023Pooled it
- Pooled it
- Magnetic resonance guided high intensity focused ultrasound (MR-HIFU) effectively reduces fibroid-related symptoms and improves quality of life-A prospective single-centre 12-month follow-up study.Acta obstetricia et gynecologica Scandinavica · 2025Trial
- Uterine and Fibroid Imaging Analysis from the FIRSTT Study.Journal of women's health (2002) · 2022Trial
- Uterine artery embolisation versus myomectomy for premenopausal women with uterine fibroids wishing to avoid hysterectomy: the FEMME RCT.Health technology assessment (Winchester, England) · 2022Trial
- Long-Term Outcomes of Uterine Artery Embolization for Treatment of Fibroids in Women Under 40: A Retrospective Survey Study at Two Institutions with Median 16-year Follow-up.Cardiovascular and interventional radiology · 2026Article
- Comparison of pregnancy outcomes in uterine fibroids following high intensity focused ultrasound ablation vs. laparoscopic myomectomy: a propensity score-matched observational study.Frontiers in surgery · 2026Article
- Robust Radiomics Models for Predicting HIFU Prognosis in Uterine Fibroids Using SHAP Explanations: A Multicenter Cohort Study.Journal of imaging informatics in medicine · 2025Article
- Progress in High Intensity Focused Ultrasound Ablation for Fertility Preservation Therapy of Uterine Fibroids and Adenomyosis.Reproductive sciences (Thousand Oaks, Calif.) · 2025Review
- Recurrence of Uterine Fibroids After Conservative Surgery or Radiological Procedures: a Narrative Review.Reproductive sciences (Thousand Oaks, Calif.) · 2024Review
- Review
- Update on Endovascular Therapy for Fibroids and Adenomyosis.Seminars in interventional radiology · 2023Review
- Embolization for the treatment of large, complex fibroids in an outpatient setting: A report of 2 cases.Radiology case reports · 2023Article
- An update on uterine artery embolization for uterine leiomyomata and adenomyosis of the uterus.The British journal of radiology · 2023Review
- Intravoxel incoherent motion diffusion-weighted MRI for predicting the efficacy of high-intensity focused ultrasound ablation for uterine fibroids.Frontiers in oncology · 2023Article
- Long-term outcome of ultrasound-guided focused ultrasound ablation for gestational trophoblastic neoplasia in the cesarean scar: a case report.BMC women's health · 2022Article
- Emerging Therapeutic Strategies for Brain Tumors.Neuromolecular medicine · 2022Review
- Should Ultrasound-Guided High Frequency Focused Ultrasound Be Considered as an Alternative Non-Surgical Treatment of Uterine Fibroids in Non-Asiatic Countries? An Opinion Paper.Journal of clinical medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundUterine leiomyomas (fibroid tumors) cause considerable symptoms in 30-50% of women and are the leading cause of hysterectomy in the United States. Women with uterine fibroid tumors often seek uterine-preserving treatments, but comparative effectiveness trials are lacking.
objectiveThe purpose of this study was to report treatment effectiveness and ovarian function after uterine artery embolization vs magnetic resonance imaging-guided focused ultrasound surgery from the Fibroid Interventions: Reducing Symptoms Today and Tomorrow study. STUDY
designThe Fibroid Interventions: Reducing Symptoms Today and Tomorrow study, which is a randomized controlled trial of uterine artery embolization vs magnetic resonance imaging-guided focused ultrasound surgery, enrolled premenopausal women with symptomatic uterine fibroid tumors; women who declined randomization were enrolled in a parallel observational cohort. A comprehensive cohort design was used for outcomes analysis. Our target enrollment was 220 women, of which we achieved 41% (n=91) in the randomized and parallel arms of the trial. Primary outcome was reintervention for uterine fibroid tumors within 36 months. Secondary outcomes were change in serum anti-Müllerian hormone levels and standardized measures of fibroid symptoms, quality of life, pain, and sexual function.
resultsFrom 2010-2014, 83 women (mean age, 44.4 years) were treated in the comprehensive cohort design (43 for magnetic resonance imaging-guided focused ultrasound surgery [27 randomized]; 40 for uterine artery embolization [22 randomized]); baseline clinical and uterine characteristics were similar between treatment arms, except for higher fibroid load in the uterine artery embolization arm. The risk of reintervention was higher with magnetic resonance imaging-guided focused ultrasound surgery than uterine artery embolization (hazard ratio, 2.81; 95% confidence interval, 1.01-7.79). Uterine artery embolization showed a significantly greater absolute decrease in anti-Müllerian hormone levels at 24 months compared with magnetic resonance imaging-guided focused ultrasound surgery. Quality of life and pain scores improved in both arms but to a greater extent in the uterine artery embolization arm. Higher pretreatment anti-Müllerian hormone level and younger age at treatment increased the overall risk of reintervention.
conclusionOur study demonstrates a lower reintervention rate and greater improvement in symptoms after uterine artery embolization, although some of the effectiveness may come through impairment of ovarian reserve. Both pretreatment anti-Müllerian hormone level and age are associated with risk of reintervention. CLINICAL TRIAL REGISTRATION NUMBER: NCT00995878, clinicaltrials.gov.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.