Phase I/II multiinstitutional study of uterine artery embolization with gelatin sponge for symptomatic uterine leiomyomata: Japan Interventional Radiology in Oncology Study Group study.
OBJECTIVE
This multicenter prospective study was conducted to evaluate the safety and the efficacy of uterine artery embolization (UAE) with gelatin sponge for symptomatic leiomyomas.


METHODS
Patients with symptomatic uterine leiomyomas were enrolled and treated with UAE. In phase I, nine patients were evaluated for safety. In phase II, 24 patients were accrued, and an intent-to-treat analysis was performed on all 33 patients. The primary endpoint was safety. Secondary endpoints included technical success, hospital stay, change in symptoms, leiomyoma volume on magnetic resonance (MR) imaging, and incidence of treatment failure.


RESULTS
UAE procedures were performed for all 33 patients. Two patients were lost to follow-up at 3 and 12 months. The median follow-up period was 33.4 months. Minor adverse events (AEs) occurred in 10 patients (33%); major AEs of permanent amenorrhea and leiomyoma expulsion occurred in two (6%). The most common AE was transient amenorrhea. Technical success was achieved in all patients. The median hospital stay was 5 days. At 12 months after UAE, menorrhagia had improved in 90% of patients, pelvic pain in 78%, and bulk-related symptoms in 97%. The mean reduction in leiomyoma volume on MR imaging at 12 months was 61%. Treatment failure occurred in one patient, who underwent hysterectomy for recurrent menorrhagia at 21 months.


CONCLUSIONS
UAE with gelatin sponge is safe, with efficacy comparable to other embolic agents based on published data. Gelatin sponge should be an option for UAE, but a prospective comparison versus other standard UAE embolic agents may be warranted.
Sone
Miyuki
M
Department of Radiology, Iwate Medical University, Uchimaru, Morioka, Japan. msone@athena.ocn.ne.jp
Arai
Yasuaki
Y
Shimizu
Tadashi
T
Takeuchi
Yoshito
Y
Higashihara
Hideyuki
H
Ohgi
Shirei
S
Ishiguchi
Tsuneo
T
Saitoh
Hiroya
H
Sakaguchi
Hiroshi
H
Tanaka
Toshihiro
T
Shioyama
Yasukazu
Y
Tanigawa
Noboru
N
D000328:Adult; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D007564:Japan; D007889:Leiomyoma / Q000473:pathology / Q000628:therapy*; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000009:adverse effects; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*