Re: Uterine-Artery Embolization versus Surgery for Symptomatic Uterine Fibroids
From: Charlie Chambers (ricechaz@earthlink.net)
Tue Jan 30 10:48:29 2007
To me, 9% retreatment rate within the first year seems too high
especially since I would anticipate that number increases
significantly within 5 years.
On Jan 30, 2007, at 8:36 AM, Dean Huffman . wrote:
> .
>
> Uterine-Artery Embolization versus Surgery for Symptomatic Uterine
> Fibroids
>
> The REST Investigators
>
> ABSTRACT
>
> Background The efficacy and safety of uterine-artery embolization,
> as compared
> with standard surgical methods, for the treatment of symptomatic
> uterine
> fibroids remain uncertain.
>
> Methods We conducted a randomized trial comparing uterine-artery
> embolization
> and surgery in women with symptomatic uterine fibroids. The primary
> outcome was
> quality of life at 1 year of follow-up, as measured by the Medical
> Outcomes
> Study 36-Item Short-Form General Health Survey (SF-36).
>
> Results Patients were randomly assigned in a 2:1 ratio to undergo
> either
> uterine-artery embolization or surgery, with 106 patients undergoing
> embolization and 51 undergoing surgery (43 hysterectomies and 8
> myomectomies).
> There were no significant differences between groups in any of the
> eight
> components of the SF-36 scores at 1 year. The embolization group
> had a shorter
> median duration of hospitalization than the surgical group (1 day
> vs. 5 days,
> P<0.001) and a shorter time before returning to work (P<0.001). At
> 1 year,
> symptom scores were better in the surgical group (P=0.03). During
> the first
> year of follow-up, there were 13 major adverse events in the
> embolization group
> (12%) and 10 in the surgical group (20%) (P=0.22), mostly related
> to the
> intervention. Ten patients in the embolization group (9%) required
> repeated
> embolization or hysterectomy for inadequate symptom control. After
> the first
> year of follow-up, 14 women in the embolization group (13%) required
> hospitalization, 3 of them for major adverse events and 11 for
> reintervention
> for treatment failure.
>
> Conclusions In women with symptomatic fibroids, the faster recovery
> after
> embolization must be weighed against the need for further treatment
> in a
> minority of patients. (ISRCTN.org number, ISRCTN23023665
> [controlled-trials.com] .)
>
> N Engl J Med. 2007 Jan 25;356(4):360-70.
> PMID: 17251532
>
> http://content.nejm.org/content/vol356/issue4/index.shtml
>
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Charlie Chambers
--
Hood River, OR
cchamber@alumni.rice.edu
"... all good things, trout as well as eternal salvation,
come by grace and grace comes by art
and art does not come easy."
-Norman Maclean
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