{"paper_id":"1d2ee153-0c02-4cb9-88d8-a4b01d8db1d9","body_text":"Abstract\nPurpose\nExploring potential risk factors for OMA recurrence, thereby contributing to the individual management of the disease and improving the patients’ prognosis.\nMethods\nData sources PubMed, Embase, the Cochrane Library, CNKI, and Wanfang data were searched systematically before October 2020. We computed the pooled odd ratios or the standard mean difference with their corresponding 95% confidence interval to investigate the impact of involved risk factors on endometrioma recurrence.\nResults\nThe pooled findings of this meta-analysis demonstrated that endometrioma relapse was closely related to age at surgery [SMD (95% CI): − 0.28 (- − 0.38 to − 0.17), P < 0.00001], CA125 level [SMD (95% CI): 0.51 (0.14–0.88), P = 0.007], cyst size [SMD (95% CI): 0.35 (0.08–0.62), P = 0.01], dysmenorrhea [OR (95% CI): 1.47 (1.07–2.02), P = 0.02], endometriosis-related surgery history [OR (95% CI): 2.60 (1.84–3.67), P < 0.00001], pre-operative medication [OR (95% CI): 2.13 (1.41–3.22), P = 0.0003], rASRM score [SMD (95% CI): 0.33 (0.20–0.46), P < 0.00001]. Furthermore, post-operative pregnancy was indicated a protective factor for preventing the OMA recurrence after surgery [OR (95% CI): 0.22 (0.09–0.56), P = 0.001]\nConclusion\nAge at surgery, CA125 level, cyst size, dysmenorrhea, endometriosis-related surgery history, pre-operative medication, rASRM score were risk factors for endometrioma relapse. In addition, post-operative pregnancy was a protective factor for preventing recurrence after surgery. However, the effect of bilateral involvement, combination with adenomyosis, or post-operative medication on endometrioma relapse need further investigations.\nSimilar content being viewed by others\nReferences\nGiudice LC, Tazuke SI, Swiersz L (1998) Status of current research on endometriosis. J Reprod Med 43(3 Suppl):252–262\nShafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, Missmer SA (2018) Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol 51:1–15. https://doi.org/10.1016/j.bpobgyn.2018.06.001\nMuzii L, Di Tucci C, Di Feliciantonio M, Galati G, Verrelli L, Donato VD, Marchetti C, Panici PB (2017) Management of endometriomas. Semin Reprod Med 35(1):25–30. https://doi.org/10.1055/s-0036-1597126\nDunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B, Heikinheimo O, Horne AW, Kiesel L, Nap A, Prentice A, Saridogan E, Soriano D, Nelen W (2014) ESHRE guideline: management of women with endometriosis. Hum Reprod 29(3):400–412. https://doi.org/10.1093/humrep/det457\nGuo SW (2009) Recurrence of endometriosis and its control. Hum Reprod Update 15(4):441–461. https://doi.org/10.1093/humupd/dmp007\nKim ML, Kim JM, Seong SJ, Lee SY, Han M, Cho YJ (2014) Recurrence of ovarian endometrioma after second-line, conservative, laparoscopic cyst enucleation. Am J Obstet Gynecol 210(3):216.e211-216. https://doi.org/10.1016/j.ajog.2013.11.007\nBozdag G (2015) Recurrence of endometriosis: risk factors, mechanisms and biomarkers. Womens Health (Lond Engl) 11(5):693–699. https://doi.org/10.2217/whe.15.56\nZheng Q, Mao H, Xu Y, Zhao J, Wei X, Liu P (2016) Can postoperative GnRH agonist treatment prevent endometriosis recurrence? Meta-analysis Arch Gynecol Obstet 294(1):201–207. https://doi.org/10.1007/s00404-016-4085-y\nZakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A (2021) Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Hum Reprod Update 27(1):96–107. https://doi.org/10.1093/humupd/dmaa033\nZakhari A, Edwards D, Ryu M, Matelski JJ, Bougie O, Murji A (2020) Dienogest and the risk of endometriosis recurrence following surgery: a systematic review and meta-analysis. J Minim Invasive Gynecol 27(7):1503–1510. https://doi.org/10.1016/j.jmig.2020.05.007\nGrandi G, Barra F, Ferrero S, Sileo FG, Bertucci E, Napolitano A, Facchinetti F (2019) Hormonal contraception in women with endometriosis: a systematic review. Eur J Contracept Reprod Health Care: Off J Eur Soci Contracept 24(1):61–70. https://doi.org/10.1080/13625187.2018.1550576\nOuchi N, Akira S, Mine K, Ichikawa M, Takeshita T (2014) Recurrence of ovarian endometrioma after laparoscopic excision: risk factors and prevention. J Obstet Gynaecol Res 40(1):230–236. https://doi.org/10.1111/jog.12164\nFerrero S, Scala C, Racca A, Calanni L, Remorgida V, Venturini PL, Leone Roberti Maggiore U (2015) Second surgery for recurrent unilateral endometriomas and impact on ovarian reserve: a case-control study. Fertil Steril 103(5):1236–1243. https://doi.org/10.1016/j.fertnstert.2015.01.032\nKoga K, Takemura Y, Osuga Y, Yoshino O, Hirota Y, Hirata T, Morimoto C, Harada M, Yano T, Taketani Y (2006) Recurrence of ovarian endometrioma after laparoscopic excision. Hum Reprod 21(8):2171–2174. https://doi.org/10.1093/humrep/del125\nTobiume T, Kotani Y, Takaya H, Nakai H, Tsuji I, Suzuki A, Mandai M (2016) Determinant factors of postoperative recurrence of endometriosis: difference between endometrioma and pain. Eur J Obstet Gynecol Reprod Biol 205:54–59. https://doi.org/10.1016/j.ejogrb.2016.07.516\nLi XY, Chao XP, Leng JH, Zhang W, Zhang JJ, Dai Y, Shi JH, Jia SZ, Xu XX, Chen SK, Wu YS (2019) Risk factors for postoperative recurrence of ovarian endometriosis: long-term follow-up of 358 women. J Ovarian Res 12(1):79. https://doi.org/10.1186/s13048-019-0552-y\nStroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012. https://doi.org/10.1001/jama.283.15.2008\nMoher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systems Control Found Appl 4(1):1. https://doi.org/10.1186/2046-4053-4-1\nCampo S, Campo V, Gambadauro P (2014) Is a positive family history of endometriosis a risk factor for endometrioma recurrence after laparoscopic surgery? Reprod Sci (Thousand Oaks, Calif) 21(4):526–531. https://doi.org/10.1177/1933719113503413\nHayasaka S, Ugajin T, Fujii O, Nabeshima H, Utsunomiya H, Yokomizo R, Yuki H, Terada Y, Murakami T, Yaegashi N (2011) Risk factors for recurrence and re-recurrence of ovarian endometriomas after laparoscopic excision. J Obstet Gynaecol Res 37(6):581–585. https://doi.org/10.1111/j.1447-0756.2010.01409.x\nKüçükbaş M, Kurek Eken M, İlhan G, Şenol T, Herkiloğlu D, Kapudere B (2018) Which factors are associated with the recurrence of endometrioma after cystectomy? J Obstet Gynaecol: J Inst Obstet Gynaecol 38(3):372–376. https://doi.org/10.1080/01443615.2017.1355897\nLee SY, Kim ML, Seong SJ, Bae JW, Cho YJ (2017) Recurrence of ovarian endometrioma in adolescents after conservative, laparoscopic cyst enucleation. J Pediatr Adolesc Gynecol 30(2):228–233. https://doi.org/10.1016/j.jpag.2015.11.001\nLee N, Min S, Won S, Cho YJ, Kim M, Kim MK, Jung YW, Yun BS, Seong SJ, Kim ML (2020) The recurrence rate of ovarian endometrioma in women aged 40–49 years and impact of hormonal treatment after conservative surgery. Sci Rep 10(1):16461. https://doi.org/10.1038/s41598-020-73434-0\nLiu X, Yuan L, Shen F, Zhu Z, Jiang H, Guo SW (2007) Patterns of and risk factors for recurrence in women with ovarian endometriomas. Obstet Gynecol 109(6):1411–1420. https://doi.org/10.1097/01.AOG.0000265215.87717.8b\nSelcuk S, Cam C, Koc N, Kucukbas M, Ozkaya E, Eser A, Karateke A (2016) Evaluation of risk factors for the recurrence of ovarian endometriomas. Eur J Obstet Gynecol Reprod Biol 203:56–60. https://doi.org/10.1016/j.ejogrb.2016.05.008\nSengoku K, Miyamoto T, Horikawa M, Katayama H, Nishiwaki K, Kato Y, Kawanishi Y, Saijo Y (2013) Clinicopathologic risk factors for recurrence of ovarian endometrioma following laparoscopic cystectomy. Acta Obstet Gynecol Scand 92(3):278–284. https://doi.org/10.1111/aogs.12051\nYuan M, Wang WW, Li Y, Gao L, Wang T, Wang SX (2014) Risk factors for recurrence of ovarian endometriomas after surgical excision. J Huazhong Univ Sci Technol [Med Sci] 34(2):213–219. https://doi.org/10.1007/s11596-014-1261-9\nTandoi I, Somigliana E, Riparini J, Ronzoni S, Vigano P, Candiani M (2011) High rate of endometriosis recurrence in young women. J Pediatr Adolesc Gynecol 24(6):376–379. https://doi.org/10.1016/j.jpag.2011.06.012\nSeo JW, Lee DY, Yoon BK, Choi D (2017) The age-related recurrence of endometrioma after conservative surgery. Eur J Obstet Gynecol Reprod Biol 208:81–85. https://doi.org/10.1016/j.ejogrb.2016.11.015\nHan S, Lee H, Kim S, Joo J, Suh D, Kim K, Lee K (2018) Risk factors related to the recurrence of endometrioma in patients with long-term postoperative medical therapy. Ginekol Pol 89(11):611–617. https://doi.org/10.5603/GP.a2018.0105\nYun BH, Jeon YE, Chon SJ, Park JH, Seo SK, Cho S, Choi YS, Lee JS, Lee BS (2015) The prognostic value of individual adhesion scores from the revised american fertility society classification system for recurrent endometriosis. Yonsei Med J 56(4):1079–1086. https://doi.org/10.3349/ymj.2015.56.4.1079\nGuzel AI, Topcu HO, Ekilinc S, Tokmak A, Kokanali MK, Cavkaytar S, Doğanay M (2014) Recurrence factors in women underwent laparoscopic surgery for endometrioma. Minerva Chir 69(5):277–282\nFauconnier A, Chapron C (2005) Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications. Hum Reprod Update 11(6):595–606. https://doi.org/10.1093/humupd/dmi029\nPorpora MG, Pallante D, Ferro A, Crisafi B, Bellati F, Benedetti Panici P (2010) Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study. Fertil Steril 93(3):716–721. https://doi.org/10.1016/j.fertnstert.2008.10.018\nVignali M, Bianchi S, Candiani M, Spadaccini G, Oggioni G, Busacca M (2005) Surgical treatment of deep endometriosis and risk of recurrence. J Minim Invasive Gynecol 12(6):508–513. https://doi.org/10.1016/j.jmig.2005.06.016\nParazzini F, Bertulessi C, Pasini A, Rosati M, Di Stefano F, Shonauer S, Vicino M, Aguzzoli L, Trossarelli GF, Massobrio M, Bracco G, Perino A, Moroni S, Beretta P (2005) Determinants of short term recurrence rate of endometriosis. Eur J Obstet Gynecol Reprod Biol 121(2):216–219. https://doi.org/10.1016/j.ejogrb.2004.11.033\nBusacca M, Chiaffarino F, Candiani M, Vignali M, Bertulessi C, Oggioni G, Parazzini F (2006) Determinants of long-term clinically detected recurrence rates of deep, ovarian, and pelvic endometriosis. Am J Obstet Gynecol 195(2):426–432. https://doi.org/10.1016/j.ajog.2006.01.078\nCoccia ME, Rizzello F, Palagiano A, Scarselli G (2011) Long-term follow-up after laparoscopic treatment for endometriosis: multivariate analysis of predictive factors for recurrence of endometriotic lesions and pain. Eur J Obstet Gynecol Reprod Biol 157(1):78–83. https://doi.org/10.1016/j.ejogrb.2011.02.008\nKikuchi I, Takeuchi H, Kitade M, Shimanuki H, Kumakiri J, Kinoshita K (2006) Recurrence rate of endometriomas following a laparoscopic cystectomy. Acta Obstet Gynecol Scand 85(9):1120–1124. https://doi.org/10.1080/00016340600627154\nBulletti C, Montini A, Setti PL, Palagiano A, Ubaldi F, Borini A (2010) Vaginal parturition decreases recurrence of endometriosis. Fertil Steril 94(3):850–855. https://doi.org/10.1016/j.fertnstert.2009.04.012\nVercellini P, DEM S, Somigliana E, Buggio L, Frattaruolo MP, Fedele L (2013) Long-term adjuvant therapy for the prevention of postoperative endometrioma recurrence: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 92(1):8–16. https://doi.org/10.1111/j.1600-0412.2012.01470.x\nChen YJ, Hsu TF, Huang BS, Tsai HW, Chang YH, Wang PH (2017) Postoperative maintenance levonorgestrel-releasing intrauterine system and endometrioma recurrence: a randomized controlled study. Am J Obstet Gynecol 216(6):582.e581-582.e589. https://doi.org/10.1016/j.ajog.2017.02.008\nWattanayingcharoenchai R, Rattanasiri S, Charakorn C, Attia J, Thakkinstian A (2021) Postoperative hormonal treatment for prevention of endometrioma recurrence after ovarian cystectomy: a systematic review and network meta-analysis. BJOG 128(1):25–35. https://doi.org/10.1111/1471-0528.16366\nFunding\nNot applicable.\nAuthor information\nAuthors and Affiliations\nContributions\nDNJ: data collection and manuscript writing with editing. XXZ: data collection. JQS and DMT: data analysis. XCN: manuscript supervision and revision.\nCorresponding author\nEthics declarations\nConflicts of interest\nThe authors declare that they have no competing interests.\nEthical approval\nNot applicable.\nConsent to participate\nNot applicable.\nConsent for publication\nNot applicable.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nJiang, D., Zhang, X., Shi, J. et al. Risk factors for ovarian endometrioma recurrence following surgical excision: a systematic review and meta‑analysis. Arch Gynecol Obstet 304, 589–598 (2021). https://doi.org/10.1007/s00404-021-06129-0\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-021-06129-0","source_license":"CC0","license_restricted":false}