Zoladex Before Ablation Leads to Better Outcomes.
The 358 premenopausal patients in the study were treated with either placebo or 3.6 mg of depot goserelin acetate (Zoladex). Two injections were given 28 days apart. The procedure was performed about 6 weeks after the first injection, Dr. George A. Vilos reported at the annual meeting of the American Association of Gynecologic Laparoscopists.
Amenorrhea rates at a 6-month follow up were 40% in the goserelin acetate group and 26% in the placebo group. At 1 year, the rates were 35% and 22%; at 3 years, they dropped to 21% in the goserelin acetate group and 14% in the placebo group.
"There was a reduction in the amenorrhea rate in both groups, but it appears Zoladex is still holding. It fares a little better [than placebo]," said Dr. Vilos of the University of Western Ontario, London.
Furthermore, the use of goserelin acetate appeared to make surgery easier and quicker by thinning the endometrium. Ultrasound evaluations performed just before endometrial ablation demonstrated a marked decrease in endometrial thickness in the goserelin acetate group, and surgeons scored the procedures in the treatment group as much easier than in the placebo group. Patients in the goserelin acetate group also absorbed less fluid.
As for surgical interventions, hysterectomies occurred in 21% of the goserelin acetate group and 15% of the placebo group. The mean time that hysterectomy patients were able to put off the procedure was 664 days in the goserelin acetate group, compared with 571 days in the placebo group.
Repeat endometrial ablation was performed in 5.6% of the goserelin acetate group and 2.1% of the placebo group. Pain and bleeding were the most common causes for surgical intervention.