title: Clinical long-term outcome after uterine artery embolization: sustained symptom control and improvement of quality of life.
abstract: OBJECTIVE
  To evaluate long-term clinical efficacy of uterine artery embolization (UAE) for uterine fibroids with respect to symptom control and improvement in quality of life.
  
  
  METHODS
  Between October 2000 and October 2007, 380 consecutive women underwent UAE. To determine long-term efficacy, the rate of reinterventions (ie, repeat UAE, hysterectomy, myomectomy) and the clinical response regarding symptoms related to bleeding and bulk were documented. Persistence, worsening, or recurrence of symptoms and reinterventions were classified as treatment failure (TF). The cumulative rate of freedom from TF was determined by Kaplan-Meier analysis. Cox regression was used to identify possible clinical or morphologic predictors of outcome. Secondary outcome measures were changes in disease-specific quality of life and onset of menopause.
  
  
  RESULTS
  Follow-up was available for a median of 5.7 years (range, 3.1-10.1 y) after treatment in 304 of 380 (80%) patients. There were 54 TFs with subsequent reintervention in 46 women. Kaplan-Meier analysis revealed a cumulative TF rate of 23.3% after 10 years. Cox regression demonstrated a significantly higher likelihood of TF in patients<40 years old compared with patients>45 years old (hazard ratio, 2.28; P = .049). Women without TF showed sustained normalization of disease-specific quality of life (P <.001). Cessation of menstruation at a median age of 51 years was reported by 57 (22.8%) of 250 women.
  
  
  CONCLUSIONS
  UAE leads to long-term control of fibroid-related symptoms and normalization of quality of life in approximately 75% of patients. Younger women seem to have a higher risk of TF than older women closer to menopause.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. christian.scheurig@charite.de
authors.forename: Christian
authors.initials: C
authors.lastname: Scheurig-Muenkler
authors.forename: Clemens
authors.initials: C
authors.lastname: Koesters
authors.forename: Maciej J
authors.initials: MJ
authors.lastname: Powerski
authors.forename: Christian
authors.initials: C
authors.lastname: Grieser
authors.forename: Vera
authors.initials: V
authors.lastname: Froeling
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Kroencke
mesh_terms: D000328:Adult; D017677:Age Distribution; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008137:Longitudinal Studies; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000706:statistics & numerical data*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*