Long-term outcome of uterine artery embolization of leiomyomata.
OBJECTIVE
To determine the long-term outcome from uterine artery embolization for leiomyomata.


METHODS
In a prospective study, 200 consecutive patients treated with uterine embolization were each followed for 5 years. Outcome, including symptom status compared with baseline, reinterventions, menstrual status, and satisfaction were recorded. Summary statistics were used to report baseline characteristics and outcome at each interval. Predictors of subsequent interventions, failure, and satisfaction with treatment were analyzed using logistic regression and Cox proportional hazards models. Failure was defined as subsequent hysterectomy, definitive myomectomy, repeat embolization, or failure of symptom improvement at the patient's final follow-up interval.


RESULTS
Of the 200 patients initially treated, 5-year follow-up was completed in 182 (91%), with 18 patients missing. At 5 years after treatment, 73% had continued symptom control, whereas 36 (20%) had failed or recurred. There had been 25 hysterectomies (13.7%), 8 myomectomies (4.4%), and 3 repeat embolizations (1.6%). Long-term failure was more likely in those not improved at 1 year (relative risk [RR] 5.73; 95% confidence interval [CI] 2.32-14.12, P < .001) and in those with baseline leiomyoma volumes greater than the median (RR 2.18; 95% CI 1.05-4.51, P = .036). After adjustment, patients in the first tertile of leiomyoma volume reduction (< or = 30.5%) were 3 times more likely to be dissatisfied with outcome compared with women in the third tertile (> or = 56.3% volume reduction) (RR 3.23; 95% CI 1 07-9.81, P = .037).


CONCLUSIONS
Uterine embolization provides durable symptom relief for most patients, with a 25% chance of failure of symptom control or recurrence over the course of a 5-year follow-up.


METHODS
II-3.
Spies
James B
JB
Department of Radiology, Georgetown University Hospital, 3800 Reservoir Road NW, Washington, DC 20007-2113, USA. spiesj@gunet.georgetown.edu
Bruno
Jill
J
Czeyda-Pommersheim
Ferenc
F
Magee
Shantel T
ST
Ascher
Susan A
SA
Jha
Reena C
RC
D000328:Adult; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018231:Leiomyomatosis / Q000098:blood supply* / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000628:therapy*