Moss, J.G., Cooper, K.G., Khaund, A., Murray, L., Murray, G.D., Wu, O. , Craig, L.E. and Lumsden, M.A. (2011) Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5-year results. BJOG: An International Journal of Obstetrics and Gynaecology, 118(8), pp. 936-944. (doi: 10.1111/j.1471-0528.2011.02952.x)
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Abstract
Objective: To compare the long-term results of uterine artery embolisation (UAE) with surgery for women with symptomatic uterine fibroids. Design Pragmatic, open, multicentre, randomised trial. Setting Twenty-seven participating UK secondary care centres. Sample: Women aged >= 18 years with symptomatic fibroids who were considered to justify surgical treatment. Methods: In total, 157 women were randomised (in a 2:1 ratio): 106 to UAE and 51 to surgery (hysterectomy 42; myomectomy nine). Main outcome measures Quality of life at 5 years, as assessed by the Short Form General Health Survey (SF-36). Secondary measures included complications, adverse events and the need for further intervention. Results: There were no significant differences between groups in any of the eight components of the SF-36 scores at 5 years (minimum P = 0.45). Symptom score reduction and patient satisfaction with either treatment was very high, with no group difference. Rates of adverse events were similar in both groups (19% embolization and 25% surgery; P = 0.40). The 5-year intervention rate for treatment failure or complications was 32% (UAE arm) and 4% (surgery arm), respectively. The initial cost benefit of UAE over surgery at 12 months was substantially reduced because of subsequent interventions, with treatments being cost neutral at 5 years. Conclusions: We have found that UAE is a satisfactory alternative to surgery for fibroids. The less invasive nature of UAE needs to be balanced against the need for re-intervention in almost a third of patients. The choice should lie with the informed patient.
| Item Type: | Articles |
|---|---|
| Additional Information: | The definitive version is available at www3.interscience.wiley.com. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Craig, Dr Louise and Wu, Professor Olivia and Lumsden, Professor Mary |
| Authors: | Moss, J.G., Cooper, K.G., Khaund, A., Murray, L., Murray, G.D., Wu, O., Craig, L.E., and Lumsden, M.A. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | BJOG: An International Journal of Obstetrics and Gynaecology |
| Publisher: | Wiley-Blackwell Publishing Ltd. |
| ISSN: | 1470-0328 |
| ISSN (Online): | 1471-0528 |
| Copyright Holders: | Copyright © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology 2011 © RCOG |
| First Published: | First published in Clinical Endocrinology 2011 118(8):936-944 |
| Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
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