Uterine fibroid embolization shows high rate of long-term symptom control

Jan 10 2006

In the first long term study of patients receiving uterine fibroid embolization (UFE) for the relief of symptoms from fibroid tumors 73% report continued relief five years later.

“This is a major step for the field, “ said James Spies, MD Chairman of Radiology at Georgetown University Hospital and principal investigator of the study. “What this study says is that the minimally invasive UFE is an effective treatment long-term, with a recurrence rate of 20%, similar to the surgical method of fibroid removal called myomectomy, which has recurrence rates of 20 to 40% at 5 years. Many patients and gynecologists have been interested in knowing how well UFE will perform in the long run and this study provides the first data to begin to answer that question.”

UFE is not for all women with fibroids but is a minimally invasive procedure that preserves the uterus and has a quicker recovery time than standard open surgery.

The purpose of the study was to determine the long-term outcome of uterine artery embolization, a procedure that uses a catheter to deliver tiny particles into the uterine arteries and cut off the blood supply to the fibroid. The benign tumors then shrink over time, with most patients having symptom relief with a month or two after treatment.

GUH’s first 200 patients to receive the treatment were followed for five years. In the first year after treatment 87% report continued relief. By the five-year mark that number was 73 percent, with these patients needing no other major therapies. Dr. Spies said, “By five years out, some of the women developed new fibroids in the uterus and began having symptoms again. Some of our patients decided to have a hysterectomy and others were treated again with UFE. This is the case with any of the uterine-sparing treatments. Growth of new fibroids is possible and we saw this occurring in some patients during the later part of follow-up in this study. This commonly occurs in women who undergo myomectomy, which is the other major therapy used for women trying to avoid hysterectomy. Given the durability of UFE demonstrated in this study, UFE will allow most women to avoid hysterectomy, which remains the most common therapy offered today. Only 13.5% of patients in this study underwent hysterectomy during the course of follow-up “

Uterine fibroids are very common non-cancerous growths on the uterine wall in up to 40 % of women over age 35 and are the principal reason for hysterectomy in over 200,000 patients in the US each year. Symptoms of fibroids include heavy menstrual bleeding and pelvic pain. African American women are at greater risk for developing fibroids, but these benign tumors are very common in women regardless of ethnic background. In 1997, Georgetown University Hospital, led by Dr. Spies, became one of the first centers in the United States to offer this treatment. To date, over 1800 hundred women have been treated at the hospital.