Leiomyoma recurrence after uterine artery embolization.
OBJECTIVE
The purpose of this study was to evaluate the rate of leiomyoma recurrence after uterine artery embolization (UAE) for symptomatic uterine leiomyomas.


METHODS
A prospective study of UAE of uterine leiomyomas has been ongoing at the authors' hospital since 1997. The recurrence rate was assessed in June 2002. Vascular access was obtained via the right common femoral artery and free-flow embolization was performed with use of 150-250- micro m polyvinyl alcohol particles and an absorbable particle sponge. Follow-up included clinical and ultrasound (US) examinations at 3, 6, and 12 months, and once per year thereafter.


RESULTS
Eighty-five UAE procedures were performed between January 1997 and June 2000. Five patients were lost to follow-up. Median follow-up was 30 months (range, 2-57 months). There were six immediate failures: one technical failure, three cases of concomitant disease (one case of endometrial cancer and two cases of adenomyosis), and two cases of large subserosal leiomyomas. There were eight late failures or recurrences: one case of leiomyoma progression, seven cases of new leiomyomas. Mean time to recurrence was 27.4 months.


CONCLUSIONS
Although UAE is an effective primary treatment for leiomyomas, this study recorded a recurrence rate of 10% at just more than 2 years. Clinical and US examinations are needed before UAE to exclude pedunculated submucosal leiomyomas and cancers, and must be repeated for more than 2 years after UAE to monitor patients' progress. Longer follow-up and more events are needed to define risk factors for recurrence.
Marret
Henri
H
Département de Gynécologie, Obstétrique, Médecine Foetale et Reproduction Humaine, Hôpital Bretonneau, Tours cedex, France. h.marret@chu-tours.fr
Alonso
Ana Maria
AM
Cottier
Jean Philippe
JP
Tranquart
François
F
Herbreteau
Denis
D
Body
Gilles
G
D001158:Arteries; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*
D011142:Polyvinyl Alcohol