The recurrence rate of ovarian endometrioma in women aged 40–49 years and impact of hormonal treatment after conservative surgery

Lee, Nara; Min, Seunggi; Won, Seyeon; Cho, Yeon Jean; Kim, Mi Kyoung; Jung, Yong Wook; Yun, Bo Hyon; Seong, Seok Ju; Kim, Miseon

doi:10.1038/s41598-020-73434-0

Cited by 9 publications

(8 citation statements)

References 29 publications

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“…In the present study, GnRH-a was administered for 3-6 months after surgery. We found that postoperative GnRH-a treatment did not signi cantly reduce the recurrence rate of endometrioma, which is consistent with those of previous studies [27,28], Muzii reported that preoperative administration of GnRH-a for three months did not signi cantly reduce the postoperative recurrence rate of ovarian endometrioma [29].…”

Section: Discussionsupporting

confidence: 92%

“…This nding is also consistent with those of previous studies [3,6]. However, in a multivariate analysis of women aged 40-49 years, ovarian endometrioma larger than 5.5 cm was the only risk factor for postoperative recurrence [27]. The ndings of some previous studies suggest that cyst size is a risk factor for recurrence of the disease [14,20].…”

Section: Discussionsupporting

confidence: 91%

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Risk Factors for Postoperative Recurrence of Ovarian Endometrioma in Young Women

Xing¹,

Song²,

Zhao³

et al. 2021

Preprint

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Background: Ovarian endometroma seriously affects women's health, and is susceptible to recurrence after surgery. However, only a few studies have been conducted to asses the risk factors for postoperative recurrence of ovarian endometrioma in young women, and no risk factors associated with recurrence have been found. The purpose of this study is to analyse the risk factors for postoperative recurrence of ovarian endometrioma in young women. Materials and Methods: We retrospectively analysed 196 young women who underwent ovarian endometrioma resection in Peking Union Medical College Hospital and Shengjing Hospital from January 2008 to January 2018 and were followed-up for at least 3 years postoperatively. The patients were divided into a recurrence group or a non-recurrence group. Their preoperative histories, laboratory indexes, intraoperative manifestations, and follow-up symptoms were analysed. Results: The cumulative recurrence rate of ovarian endometrioma in young women 3 and 5 years after surgery was 8.0%, and 20.3%, respectively. Univariate analysis showed significant differences in cancer antigen-125 levels (hazard ratio [HR]: 3.207, 95% confidence interval [CI]: 1.126–9.135, P = 0.029), the revised American Fertility Society (rAFS) disease stage (HR: 4.588, 95%CI: 1.422–14.805, P =0.011), postoperative pregnancy (HR: 0.28, 95%CI: 0.109–0.723, P = 0.008), and postoperative dysmenorrhoea (HR: 2.465, 95%CI :1.320–4.604, P = 0.005) between the two groups. Cox multivariate proportional risk analysis showed that rAFS disease stage (HR:3.783, 95%CI: 1.162–12.311, P=0.027) and postoperative dysmenorrhoea (HR: 2.291, 95%CI :1.222–4.296, P = 0.01) were risk factors for postoperative recurrence of ovarian endometrioma, whereas postoperative pregnancy (HR: 0.361, 95%CI: 0.138–0.944, P=0.038) was a protective factor for postoperative recurrence. There was no significant correlation between recurrence of ovarian endometrioma and age at surgery, age at the time of menarche, body mass index, duration of dysmenorrhoea, degree of dysmenorrhoea, genital malformation, surgical approach, maximum diameter of the cyst, and postoperative medication. Conclusion: rAFS disease stage and postoperative dysmenorrhoea are risk factors for the recurrence of ovarian endometrioma during long-term follow-up, whereas postoperative pregnancy is a protective factor.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Risk Factors for Postoperative Recurrence of Ovarian Endometrioma in Young Women

Xing¹,

Song²,

Zhao³

et al. 2021

Preprint

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“…It has been reported that the average recurrence rate of EM in 2 years is about 20% ( 0–89.6%), and the recurrence rate in 5 years is as high as 50% (15.1–56%) [ 12 ]. Lee et al [ 13 ] reported that the cumulative recurrence rates of 1 year, 2 years, 2.5 years and 5 years after ovarian endometrioma surgery are 3.7%, 6.7%, 11.1%, 16.7%, respectively. In the follow-up of patients with ovarian endometriotic cyst after surgery, Xiao-Yan Li et al [ 14 ] found that the cumulative incidence of recurrence in 5–10 years after surgery was 15.4%, 16.8%, 19.3%, 22.5%, 22.5%, 22.5%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Status and related factors of postoperative recurrence of ovarian endometriosis: a cross-sectional study of 874 cases

Yang

Bao

Tian

et al. 2023

Arch Gynecol Obstet

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Purpose Exploring the status and related factors of postoperative recurrence of ovarian endometriosis. Methods This study analyzed the results of questionnaires conducted in 27 hospitals across the country from January 2019 to November 2021. All women were divided into recurrence group and non-recurrence group to analyze the recurrence rate and related factors after ovarian endometriosis surgery. Results The recurrence rates of ovarian endometriosis within 1 year, 1–2 years, 2–3 years, 3–4 years, 4–5 years and more than 5 years were 6.27%, 35.85%, 55.38%, 65.00% and 56.82%, respectively. Significant differences were found between two groups in terms of age at surgery (OR: 0.342, 95%CI: 0.244–0.481, P < 0.001), presence of dysmenorrhea (OR: 1.758, 95%CI: 1.337–2.312, P < 0.001), presence of adenomyosis (OR: 1.948, 95%CI: 1.417–2.678, P < 0.001) and family history of endometriosis or adenomyosis (OR: 1.678, 95%CI: 1.035–2.721, P = 0.021). The age at surgery (OR: 0.358, 95%CI: 0.253–0.506, P < 0.001), presence of dysmenorrhea (OR: 1.379, 95%CI: 1.026–1.853, P = 0.033) and presence of adenomyosis (OR: 1.799, 95%CI: 1.275–2.537, P = 0.001) were significantly associated with endometrioma recurrence in multivariate analysis. No significant associations were found between the recurrence rate and body mass index (BMI), educational background, age of menarche, gravida, parity, uterine leiomyoma, endometrial polyps or postoperative use of gonadotropin-releasing hormone agonist (GnRH-a). Conclusions Dysmenorrhea and presence of adenomyosis are independent risk factors for postoperative recurrence of ovarian endometriosis, and older age is an independent protective factor for postoperative recurrence.

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“…Although drugs have shown good therapeutic effects, the following points should be considered when using them. First, high levels of estrogen induce potential side effects [ 13 ]. Second, the recurrence rate remains high.…”

Section: Introductionmentioning

confidence: 99%

UPLC-Q-TOF/MS Based Plasma Metabolomics for Identification of Paeonol’s Metabolic Target in Endometriosis

et al. 2023

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Endometriosis is a common gynecological illness in women of reproductive age that significantly decreases life quality and fertility. Paeonol has been shown to play an important part in endometriosis treatments. Understanding the mechanism is critical for treating endometriosis. In this study, autologous transplantation combined with a 28 day ice water bath was used to create a rat model of endometriosis with cold clotting and blood stagnation. The levels of estradiol and progesterone in plasma were detected by ELISA, and the pathological changes of ectopic endometrial tissue were examined by H&E staining, which proved the efficacy of paeonol. For metabolomic analysis of plasma samples, UPLC-Q/TOF-MS was combined with multivariate statistical analysis to identify the influence of paeonol on small molecule metabolites relevant to endometriosis. Finally, the key targets were screened using a combination of network pharmacology and molecular docking approaches. The results showed that the pathological indexes of rats were improved and returned to normal levels after treatment with paeonol, which was the basis for confirming the efficacy of paeonol. Metabolomics results identified 13 potential biomarkers, and paeonol callbacks 7 of them, involving six metabolic pathways. Finally, four key genes were found for paeonol therapy of endometriosis, and the results of molecular docking revealed a significant interaction between paeonol and the four key genes. This study was successful in establishing a rat model of endometriosis with cold coagulation and blood stagnation. GCH1, RPL8, PKLR, and MAOA were the key targets of paeonol in the treatment of endometriosis. It is also demonstrated that metabolomic techniques give the potential and environment for comprehensively understanding drug onset processes.

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The recurrence rate of ovarian endometrioma in women aged 40–49 years and impact of hormonal treatment after conservative surgery

Cited by 9 publications

References 29 publications

Risk Factors for Postoperative Recurrence of Ovarian Endometrioma in Young Women

Risk Factors for Postoperative Recurrence of Ovarian Endometrioma in Young Women

Status and related factors of postoperative recurrence of ovarian endometriosis: a cross-sectional study of 874 cases

UPLC-Q-TOF/MS Based Plasma Metabolomics for Identification of Paeonol’s Metabolic Target in Endometriosis

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