Is uterine artery embolization for patients with large myomas safe and effective? A retrospective comparative study in 323 patients

Hye Jeong Choi, Choi HJ, Gyeong Sik Jeon, Jeon GS, Man Deuk Kim, Jong Tae Lee, Lee JT, Jung Hyun Yoon, Yoon JH
Journal of vascular and interventional radiology : JVIR · 2013 · doi:10.1016/j.jvir.2013.02.003 · PMID:23566524
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Uterine artery embolization for large uterine fibroids demonstrated comparable volume reduction, symptom improvement, and complication rates to smaller fibroids, suggesting tumor size may not predict successful outcomes.

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Abstract

PURPOSE: To evaluate the effectiveness, safety, and complications of uterine artery embolization (UAE) in women with large fibroid tumors. MATERIALS AND METHODS: From January 2005 to February 2011, 323 patients underwent UAE for symptomatic uterine leiomyomas without adenomyosis and were included in this study. Patients were divided into two groups: those with a large tumor burden (group 1; n = 63), defined as a dominant tumor with a longest axis of at least 10 cm or a uterine volume of at least 700 cm(3); and the control group (group 2; n = 260). Tumor infarction and volume reduction were calculated based on magnetic resonance imaging findings. Symptom status was assessed with a visual analog scale. Postprocedure complications and repeat interventions were recorded. The data were analyzed with appropriate statistical tests. RESULTS: No significant differences were seen between the two groups in volume reduction of dominant tumors (46.5% in group 1 vs 52.0% in group 2; P = .082) or percentage volume reduction of the uterus (40.7% in group 1 vs 36.3% in group 2; P = .114). Also, no significant differences were seen between the two groups regarding satisfaction scores at immediate or midterm follow-up (P = .524 and P = .497) or in the presence of procedure-related complications (P = .193). CONCLUSIONS: UAE outcomes in large fibroid tumors were comparable to those in smaller tumors, without an increased risk of significant complications. Tumor size may not be a key factor in predicting successful outcomes of UAE.
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Materials and methods

From January 2005 to February 2011, 323 patients underwent UAE for symptomatic uterine leiomyomas without adenomyosis and were included in this study. Patients were divided into two groups: those with a large tumor burden (group 1; n = 63), defined as a dominant tumor with a longest axis of at least 10 cm or a uterine volume of at least 700 cm(3); and the control group (group 2; n = 260). Tumor infarction and volume reduction were calculated based on magnetic resonance imaging findings. Symptom status was assessed with a visual analog scale. Postprocedure complications and repeat interventions were recorded. The data were analyzed with appropriate statistical tests.

Results

No significant differences were seen between the two groups in volume reduction of dominant tumors (46.5% in group 1 vs 52.0% in group 2; P = .082) or percentage volume reduction of the uterus (40.7% in group 1 vs 36.3% in group 2; P = .114). Also, no significant differences were seen between the two groups regarding satisfaction scores at immediate or midterm follow-up (P = .524 and P = .497) or in the presence of procedure-related complications (P = .193).

Conclusions

UAE outcomes in large fibroid tumors were comparable to those in smaller tumors, without an increased risk of significant complications. Tumor size may not be a key factor in predicting successful outcomes of UAE. - Appears in Collections: - 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

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Condition tags

adenomyosis

MeSH descriptors

Antineoplastic Agents Chemoembolization, Therapeutic Myoma Myoma Uterine Artery Embolization Uterine Neoplasms Uterine Neoplasms Adult Antineoplastic Agents Chemoembolization, Therapeutic Female Humans Middle Aged Myoma Prevalence Republic of Korea Republic of Korea Retrospective Studies Risk Assessment Treatment Outcome

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