Uterine artery embolization is one means of treating uterine leiomyomas that avoids surgery. Marret et al identified risk factors for recurrent symptoms in a woman who has had this procedure. The authors are from Bretonneau University Hospital in Tours, France.
The recurrence free survival rate at 30 months was almost 83%.
Parameters associated with recurrent symptoms requiring further therapy:
(1) diameter of the largest (dominant) fibroid in cm
(2) number of new fibroids
Parameter
Increase in Hazard Ratio
diameter of the largest fibroid
1.7 for each 1 cm increase
number of new fibroids
1.3 for each additional fibroid
where:
• Fibroids may come in a whole spectrum of sizes. Some patients may have dozens of fibroids, most only a few millimeters in diameter. The increase in risk is probably related to the number of larger fibroids, not these tiny ones. Since ultrasound was used to evaluate the women, the smaller ones may not have detectable.
• If a woman has a large number of fibroids, then it may be difficult to know if a fibroid is really new.
The final hazard ratio was the cumulative product (see second column, top, page 463).
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