Determinant factors of postoperative recurrence of endometriosis: difference between endometrioma and pain

Tobiume, Takako; Kotani, Yoshihisa; Takaya, Hisamitsu; Tsuji, Isao; Suzuki, Ayako; Mandai, Masaki

doi:10.1016/j.ejogrb.2016.07.516

Cited by 36 publications

(31 citation statements)

References 22 publications

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“…The specific pathogenesis of EMT remains to be fully elucidated. Although EMT is a frequently occurring benign disease, it is characterized by malignant behaviors including recurrence and metastasis ( 68 , 69 ). At present, various pharmacotherapies and other methods have been proposed to treat EMT ( 70 , 71 ).…”

Section: Ccn1/cyr61 and The Female Reproductive Systemmentioning

confidence: 99%

Biological functions and role of CCN1/Cyr61 in embryogenesis and tumorigenesis in the female reproductive system (Review)

Yang

Chen

2017

Mol Med Report

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Cysteine-rich angiogenic inducer 61 (CCN1/Cyr61) is a prompt response transcription product activated by growth factors. As a member of the CCN family, it mediates cell survival, proliferation, differentiation, migration, adhesion and synthesis of the extracellular matrix by binding directly to the integrins and heparin sulfate proteoglycans or activating multiple signaling transduction pathways. It has previously been demonstrated that CCN1/Cyr61 exhibits an important role in the female reproductive system during embryogenesis and tumorigenesis. However, the functions of CCN1/Cyr61 in the female reproductive system have not been systematically investigated, therefore, the primary aim of the present review is to introduce the role and function of CCN1/Cyr61 in the female reproductive system. The current review presents the molecular structure and biological function of CCN1/Cyr61 and provides detailed data on its expression pattern and contribution to the female reproductive system, including the role in embryogenesis and tumorigenesis.

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Section: Ccn1/cyr61 and The Female Reproductive Systemmentioning

confidence: 99%

Biological functions and role of CCN1/Cyr61 in embryogenesis and tumorigenesis in the female reproductive system (Review)

Yang

Chen

2017

Mol Med Report

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“…A recurrence that led to repeated surgery developed in 21.8% of patients in our sturdy population. This value falls into the lower range of data published in the literature, where a recurrence rate of between 18.9 and 57% after 5 years is specified [ 18 – 20 , 22 , 38 – 40 ]. It should be kept in mind that in some of our patients, 14 years had passed since surgery.…”

Section: Discussionmentioning

confidence: 85%

Reproductive capacity and recurrence of disease after surgery for moderate and severe endometriosis – a retrospective single center analysis

et al. 2020

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Background Endometriosis can be associated with considerable pain and sterility. After surgical excision of moderate or severe endometriosis lesions, the rate of recurrence reaches up to 67%. The objective of this retrospective study was to establish the recurrence and pregnancy rates following surgical resection of stage III/IV endometriosis lesions. Indications for operation were endometriosis symptoms, sonographic findings and/or infertility. Methods A total of 456 patients who underwent stage III/IV endometriosis surgery between 2004 and 2014 were sent a questionnaire relating to their postoperative medical treatment, pregnancies, relief of symptoms and recurrence. Responses of 206 patients (45.2%) and their clinical data were analysed for this study. Results A total of 66.5% ( N = 137) of patients had stage III disease, and 33.5% ( N = 69) had stage IV disease. The average age was 37 years (17–59). A total of 63.1% ( N = 130) of surgeries were performed by laparoscopy, 21.8% ( N = 45) were performed by laparotomy and 15% ( N = 31) were performed by conversion. Complete resection of endometriosis lesions was achieved in 90.8% of patients ( N = 187). After surgery, 48.5% ( N = 100) of the women did not receive hormonal treatment; the main reason was the desire for children in 53%. Complete or partial relief in complaints was achieved in 93.2% ( N = 192). The rate of recurrence was 21.8% ( N = 45). The statistically significant factors that was associated with a higher risk to develop recurrence was an age < 35 ( p < 0.005). After surgery, 65.8% (79/120) of patients who wished to have children became pregnant. There was a statistically significant association among a higher postoperative pregnancy rate and age < 35 ( p < 0.003) in multivariate logistic regression analysis and laparoscopic surgical access in univariate logistic regression analysis ( p < 0.01). Conclusion We assessed the high percentage of complete or partial relief of symptoms of 93.2%, the high postoperative pregnancy rate of 65.8% and the low rate of recurrence of 21.8% compared to international literature to be very encouraging for women suffering from moderate and severe endometriosis. Though laparoscopy is considered the ‘gold standard’of endometriosis surgery, laparotomy still may be indicated in patients with extensive endometriosis especially to preserve reproductive function.

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“…About 40% of the total 1008 patients in our clinical center were followed up for <3 months, so the actual recurrence rate may be greater than the current report. In a study by Tobiume et al .,[ 7 ] rAFS score was an independent factor associated with recurrence. Chon et al .…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Recurrence of Ovarian Endometriosis in Chinese Patients Aged 45 and Over

Sun

Wang

et al. 2018

Chinese Medical Journal

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Background:When considering the issue of recurrence, perimenopausal women may have more dilemma during management comparing with young women, for example, whether to retain the uterus and ovary during surgery, whether it is necessary to add adjuvant medicine treatment after operation, and there is no evidence for reference about using of gonadotropin-releasing hormone agonist. This study aimed to study the risk factors for the recurrence of ovarian endometriosis (EM) in patients aged 45 and over.Methods:This is a retrospective nested case-control study. We reviewed the medical records of patients aged over 45 years who underwent surgical treatments for ovarian EM from 1994 to 2014, in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences. By following up to January 2016, 45 patients were found to have relapses and regarded as the recurrence group. The patients with no recurrence during the same follow-up period were randomly selected by the ratio of 1:4 as the nonrecurrence group (180 patients in total). Stratified Cox regression was used to analyze the risk factors of the recurrence.Results:Univariate analysis showed that there was a significant difference in the postoperative treatment (the percentage of patients who received postoperative treatment in non-recurrence group and recurrence group, 23.9% vs. 40.0%, χ2 = 4.729, P = 0.030) and ovarian preservation (the percentage of patients who received surgery of ovarian preservation in non-recurrence group and recurrence group, 25.0 % vs. 44.4%, χ2 = 19.462, P < 0.001) between the nonrecurrence group and the recurrence group. There was no correlation between recurrence and the following factors including patient's age, menarche age, gravidity, parity, CA125 level, ovarian lesions, menopausal status, combined benign gynecological conditions (such as myoma and adenomyoma) and endometrial abnormalities, and surgical approach or surgical staging (all P > 0.05). Multivariate analysis indicated that whether to retain the ovary was the only independent risk factor of recurrence for patients aged 45 years and over with ovarian EM (odds ratio: 5.594, 95% confidence interval: 1.919–16.310, P = 0.002).Conclusion:Ovarian preservation might be the only independent risk factor of recurrence for patients aged 45 years and over with ovarian EM.

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Determinant factors of postoperative recurrence of endometriosis: difference between endometrioma and pain

Cited by 36 publications

References 22 publications

Biological functions and role of CCN1/Cyr61 in embryogenesis and tumorigenesis in the female reproductive system (Review)

Biological functions and role of CCN1/Cyr61 in embryogenesis and tumorigenesis in the female reproductive system (Review)

Reproductive capacity and recurrence of disease after surgery for moderate and severe endometriosis – a retrospective single center analysis

Risk Factors for Recurrence of Ovarian Endometriosis in Chinese Patients Aged 45 and Over

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