Analysis Shows Similar Efficacy for UFE Versus Myomectomy, With Greater Improvement in Menorrhagia and Less Need for Blood Transfusion
March 25, 2019—Research presented at the Society of Interventional Radiology's (SIR) Annual Scientific Meeting found that patients with uterine fibroids treated via embolization (UFE) were less likely to require blood transfusions than those treated with surgical myomectomy and that similar efficacy could be expected between the procedures. Jemianne Bautista-Jia, MD, a radiology resident at Kaiser Permanente in Los Angeles, California, presented data from a long-term retrospective analysis of 863 patients treated from 2008 through 2014 showing comparable efficacy and durability marks for the two procedures, with a slightly lower need for secondary procedures after UFE than myomectomy, as well as greater improvement in menorrhagia.
Half of the patients included in the analysis were treated with UFE and the other half underwent the surgical procedure. With an average follow-up of 7 years, the study showed a 0.9% rate of postprocedural blood transfusion in UFE-treated patients compared to 2.9% for myomectomy. Both groups showed significant increases in hemoglobin at 1 year, and the rates of secondary interventions were comparable though lower in the interventional arm, at 8.9% for UFE and 11.2% for myomectomy. Improvement in menorrhagia was observed in 75.4% in the UFE group versus 49.5% with myomectomy.
More women in the myomectomy group became pregnant during the follow-up period (84 vs 6), though the mean age in the UFE group was 45.2 years versus 38.7 for patients treated with myomectomy and patients in the participating institutions are pre-screened for the desire to preserve fertility prior to UFE.
Dr. Bautista-Jia summarized that the clinical takeaways of the study are that for patients with primary complaints of menorrhagia, UFE is the more effective treatment. If their primary complaints are bulk symptoms, the procedures have similar outcomes. With this in mind, the investigators believe UFE should be considered in every woman with symptomatic uterine fibroids.
Addressing the media, Dr. Bautista-Jia and outgoing SIR President Victoria Marx, MD, emphasized the need for increased patient awareness of UFE as an alternative to surgery for uterine fibroids. Dr. Bautista-Jia also noted that UFE is usually less costly and involves less time admitted to the hospital, and that it has fewer contraindications than surgery.