REGULAR CONTENT
Final ID
403
Type
Original Scientific Research-Oral or Pos
Authors
D Daye1, R Watanabe1, V Furtado1, J Petrozza1, G Martinez-Salazar1
Institutions
1Massachusetts General Hospital, Boston, MA
Purpose
The use of uterus-sparing treatments (UST) is increasing for the management of symptomatic fibroids (SF). The purpose of this study is to compare the factors associated with choosing uterine artery embolization (UAE) versus surgical myomectomy (SM) for fibroid treatment.
Materials & Methods
In this IRB-approved single-center retrospective study, we identified 163 patients who underwent SM and UAE between January 2004 and December 2010. The following pre-procedure data was collected from each patient's medical record: demographics, parity, baseline symptoms, history of prior surgical treatment, family history of fibroids or gynecologic cancer, and predominant type of fibroid. Patients were stratified based on treatment received: UAE versus SM. Univariate and multivariate logistic regression were performed to assess the factors associated with type of fibroid treatment. To reduce the effect of feature multicollinearity, stepwise backward feature selection was performed.
Results
Of the 163 women included in the study: 45.4% (n=74) underwent SM and 54.6% (n=89) underwent UAE. Univariate logistic regression revealed that menopause status, gastrointestinal/genitourinary (GI/GU) symptoms, bulk symptoms, infertility, fibroid type, patient's race, educational level and age were significantly associated with type of fibroid treatment received (p<0.05; Wald test). Multivariate logistic regression with stepwise feature elimination revealed that older age (OR=1.2; p<0.01), post-menopause (OR=3.1; p=0.02), bulk symptoms (OR=3.2; p<0.01), fibroid type (intramural and subserosal) (OR=2.8 and 5.4; p=0.04 and p<0.01), and GI/GU symptoms (OR=4.2; p=0.03) were significantly associated with choice of UAE treatment, while infertility (OR=0.1; p<0.01) was significantly associated with choice of SM treatment.
Conclusions
Patient's age, menopause status, baseline symptoms, fertility and fibroid type were found to be associated with choice of uterine artery embolization versus surgical myomectomy for fibroid treatment. Further assessment of these factors may improve pre-procedure patient counseling and personalize management decisions in patients interested in uterus-sparing treatments for symptomatic fibroids.
Final ID
403
Type
Original Scientific Research-Oral or Pos
Authors
D Daye1, R Watanabe1, V Furtado1, J Petrozza1, G Martinez-Salazar1
Institutions
1Massachusetts General Hospital, Boston, MA
Purpose
The use of uterus-sparing treatments (UST) is increasing for the management of symptomatic fibroids (SF). The purpose of this study is to compare the factors associated with choosing uterine artery embolization (UAE) versus surgical myomectomy (SM) for fibroid treatment.
Materials & Methods
In this IRB-approved single-center retrospective study, we identified 163 patients who underwent SM and UAE between January 2004 and December 2010. The following pre-procedure data was collected from each patient's medical record: demographics, parity, baseline symptoms, history of prior surgical treatment, family history of fibroids or gynecologic cancer, and predominant type of fibroid. Patients were stratified based on treatment received: UAE versus SM. Univariate and multivariate logistic regression were performed to assess the factors associated with type of fibroid treatment. To reduce the effect of feature multicollinearity, stepwise backward feature selection was performed.
Results
Of the 163 women included in the study: 45.4% (n=74) underwent SM and 54.6% (n=89) underwent UAE. Univariate logistic regression revealed that menopause status, gastrointestinal/genitourinary (GI/GU) symptoms, bulk symptoms, infertility, fibroid type, patient's race, educational level and age were significantly associated with type of fibroid treatment received (p<0.05; Wald test). Multivariate logistic regression with stepwise feature elimination revealed that older age (OR=1.2; p<0.01), post-menopause (OR=3.1; p=0.02), bulk symptoms (OR=3.2; p<0.01), fibroid type (intramural and subserosal) (OR=2.8 and 5.4; p=0.04 and p<0.01), and GI/GU symptoms (OR=4.2; p=0.03) were significantly associated with choice of UAE treatment, while infertility (OR=0.1; p<0.01) was significantly associated with choice of SM treatment.
Conclusions
Patient's age, menopause status, baseline symptoms, fertility and fibroid type were found to be associated with choice of uterine artery embolization versus surgical myomectomy for fibroid treatment. Further assessment of these factors may improve pre-procedure patient counseling and personalize management decisions in patients interested in uterus-sparing treatments for symptomatic fibroids.