Leiomyoma recurrence after uterine artery embolization

Henri Marret, H. Marret, Marret H, Alonso AM, Ana Maria Alonso, Ana M. Fernández‐Alonso, Jean Philippe Cottier, Jean‐Philippe Cottier, Tranquart F, François Tranquart, Herbreteau D, Denis Herbreteau, Gilles Body, G Body, Body G
Journal of vascular and interventional radiology : JVIR · 2003 · vol. 14(11) , pp. 1395–1399 · doi:10.1097/01.rvi.0000096773.74047.5a · PMID:14605104 · W2140167370
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This study investigated factors associated with leiomyoma recurrence after uterine artery embolization, reporting findings on the prevalence and predictive variables for symptom reoccurrence.

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Abstract

PURPOSE: The purpose of this study was to evaluate the rate of leiomyoma recurrence after uterine artery embolization (UAE) for symptomatic uterine leiomyomas. MATERIALS AND 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.

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MeSH descriptors

Embolization, Therapeutic Embolization, Therapeutic Leiomyoma Uterine Neoplasms Uterus Arteries Arteries Female Female Follow-Up Studies Follow-Up Studies Humans Humans Leiomyoma Leiomyoma Leiomyoma Middle Aged Middle Aged Neoplasm Recurrence, Local Neoplasm Recurrence, Local

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