Polypoid endometriosis mimicking malignancy: a clinicopathological analysis of 28 cases and literature review

Polypoid endometriosis mimicking malignancy: a clinicopathological analysis of 28 cases and literature review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Polypoid endometriosis mimicking malignancy: a clinicopathological analysis of 28 cases and literature review Yang Li, Qiqi Xu, Linghui Li, Changkun Zhu, Elaine Fleming, Hao Chen, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3106485/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Polypoid endometriosis (PEM) is rare benign tumors with morphological features resembling malignant tumors. We aimed to analyze the clinicopathological features and outcomes of patients with PEM, and compare them to cases of endometriosis with malignant transformation. Methods In total 28 PEM and 44 cases of endometriosis with malignant transformation were retrospectively analyzed. Data from each of the patients was collected including clinicopathological features, treatment, and outcomes for evaluation. Results In the PEM group patients were aged 30 to 63 years (mean, 40.7 years). The most common clinical symptoms were pelvic mass, irregular vaginal bleeding, and lower abdominal pain. The primary sites were ovary, posterior vaginal fornix, rectum, uterosacral ligament, and abdominal incision. The PEM tumors had a median maximum diameter of 5.3 cm (IQR, 3.1–7.9). The follow-up data in the PEM group showed that 23/27 patients survived without residual disease, 3/27 patients survived with residual endometriosis, 1/27 patient survived with endometriosis-malignant low-grade endometrial stromal sarcoma (ESS). Compared with patients in the endometriosis with malignant transformation group, there were statistically significant differences in age, menopause, dysmenorrhea, adenomyosis, cancer antigen 125 (CA125) levels, and tumor size. Conclusions PEM is a benign lesion and has a risk of malignant transformation. Patients with PEM were younger with a smaller tumor size and a higher CA125 level when compared to patients with endometriosis with malignant transformation, which provides important information for the correct diagnosis of PEM. Polypoid endometriosis Clinicopathological features Cancer antigen 125 Background Polypoid endometriosis (PEM) is a rare benign tumor that forms multiple polypoid nodules in the female pelvis mimicking malignant tumors and was first described by Mostoufizadeh and Scully in 1980[ 1 ]. Because of its rare incidence and non-specific presentation, the diagnosis of PEM is commonly delayed or missed. Due to the morphological features it is difficult to distinguish malignant tumor from PEM preoperatively[ 2 ]. Therefore, it often brings a heavy psychological burden to the patients and their families. Since it is so difficult to distinguish PEM from malignancy preoperatively most patients undergo a hysterectomy which can have devastating consequences for young women of childbearing age if they desire future fertility. It is known that the current understanding of PEM is far from complete. To date, publications on PEM have been limited, and only one report with a large set of cases (24 patients) has been clinicopathologically analyzed[ 2 ]. In this study, we conduct a relatively large retrospective analysis focused on the clinicopathological features and outcome of PEMs to provide a useful reference for the diagnosis and treatment of such tumors. Materials and methods Patients and samples Patients with a final diagnosis of PEM (n = 28) and endometriosis with malignant transformation (n = 44) were identified in our hospital from January 2011 to December 2021. Hematoxylin and eosin (H&E) and immunohistochemical (IHC) staining slides were reviewed by 2 gynecologic pathologists in a blinded fashion and the pathologic diagnosis was confirmed. All related clinical data were extracted from the electronic clinical information system database. The normal upper limitation of serum CA125 was defined as 35U/ml. This study was approved by the Ethics Committee of the Women's Hospital, School of medicine, Zhejiang University (NO: IRB-20220349-R). Statistical analysis The software program SPSS, version 26.0 (IBM, Armonk, NY, USA), was used for statistical analysis. Before performing specific statistical tests, we performed tests for normality and homogeneity of variance. Means ± SD (χ- ± s) or median (inter-quartile range) for normal and non-normally distributed data, respectively. Statistical comparisons between groups were made using t-test or non-parametric test. Categorical variables, expressed as percentages, were evaluated using the chi-square test or Fisher's exact test. P < 0.05 was considered statistically significant. Results 1. Clinicopathological features of patients Among the 28 PEM cases, 18/28 (64.3%) the most common location was ovarian, followed by posterior vaginal fornix (3/28, 10.7%), rectum (3/28, 10.7%), uterosacral ligament (3/28, 10.7%), and abdominal incision (1/28, 3.6%). In terms of surgical treatment 13/28 patients (46.4%) underwent ovarian cyst removal, 6/28 (21.4%) underwent bilateral salpingo-oophorectomy (BSO), 4/28 (14.3%) total abdominal hysterectomy (TAH) along with BSO, 2/28 (7.1%) TAH along with ovarian cyst removal, 1/28 (3.6%) had only mass removal, 1/28 (3.6%) myomectomy, and 1/28 (3.6%) myomectomy of broad ligament. Among the 44 endometriosis with malignant transformation cases, 39/44 (88.6%) were located at the ovary, followed by rectum (2/44, 4.5%), posterior vaginal fornix (1/44, 2.3%), intramural space of uterus (1/44, 2.3%) and abdominal incision (1/44, 2.3%). 32/44 (70.5%) patients received trans abdominal radical surgery (TAH + BSO + pelvic and paraaortic lymphadenectomy + omentectomy), 11/44 (25%) patients received laparoscopic radical surgery, and 1/44 (2.3%) received mass removal. Detailed analysis is shown in table1, 2. 2. Clinical features of PEM and compared to endometriosis malignant transformation Patients in the PEM group were 30 to 63 years old (mean 40.7 years). Of the 28 patients, 6/28 (21.4%) had a history of endometriosis, 10/28 (35.7%) had a history of adenomyosis, 18/28 (64.3%) had dysmenorrhea, and 4/28 (14.3%) were diagnosed with female infertility. Human epididymis secretion protein 4 (HE4) was 47.5 U/mL (IQR, 38.8–52.6). The median maximum tumor diameter was of 5.3 cm, with a maximum of 26.4 cm. Compared with the malignant endometriosis group, patients in the PEM group were younger (40.7 ± 7.3 vs. 47.1 ± 7.1, P < 0.001) and thus the percentage of postmenopausal women was lower (3.6% vs. 34.1%, P = 0.002). Dysmenorrhea was significantly more common in the PEM group as compared to the malignant endometriosis group (64.3% vs. 20.5%, P < 0.001). The incidence of adenomyosis was also much higher in the PEM group (35.7% vs. 2.3%, P < 0.001) and the median maximum tumor diameter was smaller [5.3 (IQR, 3.1–8.0) vs. 9.4 (IQR, 6.6–11.8), P < 0.001]. In addition, we compared the serum level of CA125 between patients with PEM and endometriosis with malignant transformation. For the PEM group, the serum levels of CA125 were available in 27 cases, 21/27 (77.8%) showed elevated levels of CA125. Interestingly, in the malignant endometriosis group 40 cases had serum CA125 levels available and only 13/40 (32.5%) had elevated levels of CA125. The median value of CA125 was 92.1 U/mL (IQR, 48.4–360.9) in the PEM group, which was higher than that in the malignant endometriosis group [92.1 (IQR, 48.4–360.9) vs. 31.2 (IQR, 18.7–58.2), P < 0.001]. Detailed analysis is shown in table 1, 2. 3. Follow-up of PEM and endometriosis with malignant transformation In total 27 PEM and 39 endometriosis with malignant transformation patients had complete follow-up information available. Median follow-up time for both groups was 49.0 months (IQR, 14.75–78.5). In PEM cases, 23/27 (85.2%) survived without recurrence, 3/27 (11.1%) survived with radiographic recurrence, 1/27 (3.7%) survived but was found to have endometriosis with malignant transformation of low-grade endometrial stromal sarcoma (LG-ESS). In the endometriosis with malignant transformation cases, 37/39 (94.9%) survived without recurrence, 2/39 (5.1%) developed recurrence. Detailed analysis is shown in table 1, 2. Discussion PEM is rare, most often found incidentally, and has a risk of malignant transformation. However, there are very few cases and clinicopathologic reports, making it difficult to provide consensus or guidelines for clinical practice. Thus, we explore the clinicopathological features and outcome of PEMs to provide important information for the correct diagnosis of PEM. Literature Review A literature review was conducted in this report by searching PubMed between 1990 and 2022 using the keyword “polypoid endometriosis”. This search yielded 69 PEM cases (Table 3). The average age was 47.5 years, and 30 of them were younger than 45 years old. With in the 69 cases reviewed there were no typical symptoms of PEM, 13 presented with abdominal or back pain, 13 had a pelvis mass, 8 had abnormal vaginal bleeding, and 8 had dysmenorrhea. In addition, serum CA 125 levels were available for 19 of the PEM cases. 17 of those cases had elevated serum CA 125 levels. Preoperative hormone therapy is a possible diagnostic treatment option for PEM. In the literature review, 22 patients had a history of hormonal therapies (including hormone replacement therapy, Tamoxifen, and oral contraception), which, in a sense, supports that PEM is an estrogen-dependent tumor. Thirty-seven of the 69 cases were followed up with no evidence of disease, 3 cases survived with radiographic recurrence, and 1 case developed endometrial cancer eight months after surgery. The rest were lost to follow up. These findings indicate that PEM has a propensity for local recurrence and a low risk of malignant transformation. The potential for malignant transformation of PEM has been cited as an indication for surgical resection, even in asymptomatic patients[3]. Summary of Main Results in the Present Study The clinical manifestations of the 28 cases of PEM and 44 cases of endometriosis with malignant transformation are summarized in Table1, 2. Compared with patients in the endometriosis with malignant transformation group, patients in the PEM group were younger, mainly of childbearing age and a lower percentage of postmenopausal patients. The PEM patients had a higher percentage of dysmenorrhea, a smaller maximum tumor diameter, and a higher CA125 level. In the 28 PEM group, most were of childbearing age at the time of diagnosis, and no association with premenopausal women was found. In contrast Parker et al.[2] suggested that PEM often occurred in post-menopausal women as 60% of the patients in that study were over 50. This difference may be due to the fact that the majority of the cases reported in the literature were consultation cases, which is related to selection bias. Moreover, ethnicity may be another possible reason. Most of the patients in this study had no typical presenting symptoms, and the pelvic tumors were discovered incidentally by pelvic ultrasonography during routine pelvic exams. Some PEM patients had irregular vaginal bleeding with or without abdominal pain. Endometriosis is a common condition among women of reproductive age and is a leading cause of infertility, affecting more than 10% of women of reproductive age for unknown reasons[4, 5]. As a unique form of endometriosis, PEM might affect fertility. In our patient cohort 14.3% of the 28 PEM patients were diagnosed with infertility and none became pregnant during the follow-up period, although it is not known what percent of these patients were attempting pregnancy. CA125, a well-established marker for epithelial cell ovarian cancer, is derived from coelomic epithelia including the endometrium, fallopian tube, ovary, and peritoneum[6]. In our study, patients in PEM group showed higher median value of CA125 than the endometriosis malignant group. Kadan et al.[7] suggested that erroneously elevate CA125 levels in patients with endometriosis make the differentiation between benign and malignant cysts challenging for gynecologists. Therefore, the level of CA125 lacks specificity in diagnosing malignant transformation of endometriosis. Results in the Context of Published Literature The exact pathogenesis of PEM is still unclear, and medical history provides essential information for the correct diagnosis. In the studies reviewed nearly 50% of patients with PEM in the literature were reported to receive hormonal treatment (either unopposed estrogen or mixed estrogen-progestin therapy) at the time of diagnosis[8]. Othman et al.[9] reported a case of PEM in a woman with recurrent endometriosis following GnRH agonist withdrawal and postulated that the lesion was a rebound phenomenon upon withdrawal of GnRH agonist-induced hormonal suppression. In another reported case, a 62-year-old woman who took tamoxifen for two years following partial mastectomy for breast cancer developed multiple “endometriotic polyps” on the cervical serosa and both ovaries[10]. However, only 4/28 patients in this study had any lifetime use of hormonal therapy since oral contraceptives are not widely used in China. Therefore, there is insufficient evidence for a causal link between hormonal treatment and PEM. Recurrence rates after surgical treatment of endometriosis vary widely in the literature. The mean recurrence rate of endometriosis is estimated to be around 20% at the 2 nd year of follow-up and up to 50% at 5 th year[8]. During the follow-up of the present study, there were 3 cases of radiographic recurrence with a recurrence rate of 11.1% at 4 th year. There are few reports on the malignant transformation of PEM in the current literature. Takeuchi et al.[11] reported a case of PEM with malignant transformation: a 52-year-old woman (gravida 2, para 2) who had not received hormone therapy and was surgically confirmed to have atypical endometrial hyperplasia with well-differentiated endometrioid carcinoma which was considered as the malignant transformation of PEM. Carbone et al.[12] reported on a 53-year-old nulliparous woman who had been treated for over 10 years for recurrent and symptomatic pelvic PEM and underwent four surgical resections during that time. The pathology from her last resection showed a rare myxoid low-grade endometrial stromal sarcoma (ESS) that had arisen with in the PEM. Similarly, in our study there was one patient, a 42-year-old woman (gravida 2, para 1) who had not received any hormonal treatment or Tamoxifen, that developed low-grade endometrial stromal sarcoma after PEM. In our study as well as in previous literature, PEM manifests as a polypoid mass within an ovarian endometrioma, mimicking ovarian cancer, or as discrete lesions in the pelvic cavity protruding to adjacent structures simulating peritoneal dissemination or malignant tumors[11]. Macroscopically, nodules are various shades of white-gray, pink-red, or yellow-brown, and usually softer than malignant tumors. Microscopically, polypoid lesions are covered by monolayered columnar to cuboidal epithelial cells on the surface and have a dense cellular stroma under the epithelial layer. Strengths and Weaknesses To our knowledge, this is the largest clinicopathologic analysis and literature review of PEM. It is also the first study to compare PEM and endometriosis with malignant transformation to help clinicians differentiate between the two and improve the accuracy of preoperative diagnosis. As this study was a relatively small retrospective study from a single institution, the possibility of confounding variables cannot be entirely excluded. Implications for Practice and Future These results should be further validated through larger, multi-institutional studies. Further work is required to establish better examination and find more typical clinical manifestation for accurate diagnosis and appropriate treatment in clinical practice. Conclusion PEM is a benign lesion with rare incidence and non-specific presentation, diagnosis might be delayed or missed. Patients with PEM often have dysmenorrhea, history of adenomyosis, pelvic masses and elevated serum CA125. Our study shows patients with PEM have a low risk for malignant transformation. Due to the lack of specific clinical features and laboratory tests, preoperative diagnosis of PEM is difficult. The patient’s medical history and laboratory tests provide important information for the correct diagnosis for PEM. Abbreviations PEM: Polypoid endometriosis ESS: Endometrial stromal sarcoma CA125: Cancer antigen 125 H&E: Hematoxylin and eosin IHC: Immunohistochemical IQR: Inter-quartile range BSO: Bilateral salpingo-oophorectomy TAH: Total abdominal hysterectomy HE4: Human epididymis secretion protein 4 LG-ESS: Low-grade endometrial stromal sarcoma Declarations Ethics approval and consent to participate All procedures performed in studies involving human participants were following the ethical standards of the national and/or national research committee and with the Helsinki declaration. Informed consent was obtained from all subjects and/or their legal guardian(s). The study was approved by the Institutional Review Board at Zhejiang University School of Medicine Women’s Hospital, China (NO: IRB-20220349-R). All data were anonymized to maintain patient privacy. Consent for publication Not applicable. Availability of data and materials All data generated or analysed during this study are included in this published article. Competing interests The authors report no conflicts of interest in this work. Funding No specific funding was disclosed. Authors' contributions QQ. X and YL designed the study; QQ. X, CK. Z and FZ recruited the patients and collected patient material; QQ. X and LH. L performed the statistical analysis. YL, FZ, Elaine F and HC drafted the manuscript, and all authors critically reviewed and revised the manuscript. FZ is the guarantor of this work and as such had full access to all data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All researchers listed as authors are independent from the funders, and all final decisions about the research were made without constraint by the investigators. Acknowledgements Not applicable. References Mostoufizadeh M, Scully RE. Malignant tumors arising in endometriosis. Clin Obstet Gynecol. 1980;23(3):951–63. Parker RLMD, Farnaz MD, Young, Robert HMD, Clement PBMD. Polypoid Endometriosis: A Clinicopathologic Analysis of 24 Cases and a Review of the Literature. Am J Surg Pathol 2004. Alborzi S, Zarei A, Alborzi S, Alborzi M. Management of ovarian endometrioma. Clin Obstet Gynecol. 2006;49(3):480–91. Tan Z, Hung SW, Zheng X, Wang CC, Chung JP, Zhang T. What We Have Learned from Animal Models to Understand the Etiology and Pathology of Endometrioma-Related Infertility. Biomedicines 2022, 10(7). Gupta S, Goldberg JM, Aziz N, Goldberg E, Krajcir N, Agarwal A. Pathogenic mechanisms in endometriosis-associated infertility. Fertil Steril. 2008;90(2):247–57. Jacobs I. Screening for ovarian cancer by CA-125 measurement. Lancet. 1988;1(8590):889. Kadan Y, Fiascone S, McCourt C, Raker C, Granai CO, Steinhoff M, Moore RG. Predictive factors for the presence of malignant transformation of pelvic endometriosis. Eur J Obstet Gynecol Reprod Biol. 2015;185:23–7. Ceccaroni M, Bounous VE, Clarizia R, Mautone D, Mabrouk M. Recurrent endometriosis: a battle against an unknown enemy. Eur J Contracept Reprod Health Care. 2019;24(6):464–74. Othman NH, Othman MS, Ismail AN, Mohammad NZ, Ismail Z. Multiple polypoid endometriosis–a rare complication following withdrawal of gonadotrophin releasing hormone (GnRH) agonist for severe endometriosis: a case report. Aust N Z J Obstet Gynaecol. 1996;36(2):216–8. Jaegle WT, Barnett JC, Stralka BR, Chappell NP. Polypoid endometriosis mimicking invasive cancer in an obese, postmenopausal tamoxifen user. Gynecol Oncol Rep. 2017;22:105–7. Takeuchi M, Matsuzaki K, Furumoto H, Nishitani H. Case report: A case of polypoid endometriosis: MR pathological correlation. Br J Radiol. 2008;81(964):e118–119. Carbone F, Kaur MM, Chok AY, Kontovounisios C, Ind T, Rasheed S. Endometrial stromal sarcoma arising from polypoid endometriosis: Case report and literature review. Int J Surg Case Rep. 2020;72:537–40. Miyoshi S, Yamaguchi K, Chigusa Y, Sunada M, Yamanoi K, Horie A, Hamanishi J, Kondoh E, Mandai M. Fertility preservation of polypoid endometriosis: Case series and literature review. J Obstet Gynaecol Res. 2022;48(2):502–9. Jacquot A, Gertych W, Golfier F, Devouassoux-Shisheboran M, Rousset P. Polypoid endometriosis of the Douglas pouch. Radiol Case Rep. 2021;16(3):612–4. Ling R, Jin H, Yang Y, Cheng L. Polypoid Endometriosis of the Rectum and Vagina in an Adolescent. J Pediatr Adolesc Gynecol. 2020;33(5):581–5. Ghafoor S, Lakhman Y, Park KJ, Petkovska I. Polypoid endometriosis: a mimic of malignancy. Abdom Radiol (NY). 2020;45(6):1776–82. Tsai C, Huang SH, Huang CY. Polypoid endometriosis - A rare entity of endometriosis mimicking ovarian cancer. Taiwan J Obstet Gynecol. 2019;58(3):328–9. Tabakin AL, Dutton JL, Fatima A, Sadimin E, Jang TL. Polypoid Endometriosis Presenting as a Renal Cortical Tumor. Urology. 2018;119:e5–e7. Ramai D, Linn S, Murphy T, Reddy M. Transmural Polypoid Endometriosis of the Sigmoid Colon. J Gastrointest Surg. 2018;22(12):2184–6. Laopakorn S, Huang KG. Polypoid Endometriosis of Urinary Bladder. Gynecol Minim Invasive Ther. 2018;7(2):86–7. Zhuang L, Eisinger D, Jaworski R. A case of ureteric polypoid endometriosis presenting in a post-menopausal woman. Pathology. 2017;49(4):441–4. Iida Y, Tabata J, Yorozu T, Kitai S, Ueda K, Saito M, Yanaihara N, Yamada K, Okamoto A. Polypoid endometriosis of the ovary and müllerianosis of pelvic lymph nodes mimicking an ovarian carcinoma with lymph node metastasis. Int Cancer Conf J. 2017;6(4):145–8. Han K, Li X, Bhargava R, Taylor S, Lee K, Yadav D. Polypoid Endometriosis Presenting as a Colonic Mass. ACG Case Rep J. 2017;4:e39. Yamamoto A, Usami T, Kondo E, Kato K, Motoyama T. Huge polypoid endometriosis: report of a case and review of the literature. Int Cancer Conf J. 2016;5(1):31–5. Tham WP, Busmanis I, Tan WC, Kwek JW. Polypoid endometriosis of post vaginal fornix: utility of MRI imaging of pelvis with diffusion weighted imaging for diagnosis. Med J Malaysia. 2016;71(3):144–6. Takeuchi M, Matsuzaki K, Bando Y, Nishimura M, Yoneda A, Harada M. A case of polypoid endometriosis with malignant transformation. Abdom Radiol (NY). 2016;41(9):1699–702. Kim JY, Song TJ, Choi HK, Shim JY. Multifocal Polypoid Endometriosis Mimicking Malignancy in a Young Woman with a History of Hormonal Treatment. J Pathol Transl Med. 2015;49(5):418–20. Gunawardane DN, Allen PW. Selected Case From the Arkadi M. Rywlin International Pathology Slide Club: Polypoid Endometriosis in the Pouch of Douglas in a Perimenopausal Woman. Adv Anat Pathol. 2015;22(5):331–4. Gezer NS, Seçil M, Ulukuş E, Celiloğlu M. Polypoid endometriosis presenting as a mass at the pouch of Douglas. J Obstet Gynaecol. 2015;35(8):861–2. Choi IH, Jin SY, Jeen YM, Lee JJ, Kim DW. Tamoxifen-associated polypoid endometriosis mimicking an ovarian neoplasm. Obstet Gynecol Sci. 2015;58(4):327–30. Yamada Y, Miyamoto T, Horiuchi A, Ohya A, Shiozawa T. Polypoid endometriosis of the ovary mimicking ovarian carcinoma dissemination: a case report and literature review. J Obstet Gynaecol Res. 2014;40(5):1426–30. Jaiman S, Gundabattula SR, Pochiraju M, Sangireddy JR. Polypoid endometriosis of the cervix: a case report and review of the literature. Arch Gynecol Obstet. 2014;289(4):915–20. Koyama S, Kobayashi M, Tanaka Y, Isobe M, Miwa H, Shiki Y. Laparoscopic repair of a post-myomectomy spontaneous uterine perforation accompanied by a bizarre tumor resembling polypoid endometriosis. J Minim Invasive Gynecol. 2013;20(6):912–6. Kozawa E, Inoue K, Iwasa N, Fujiwara K, Yasuda M, Tanaka J, Kimura F. MR imaging of polypoid endometriosis of the ovary. Magn Reson Med Sci. 2012;11(3):201–4. Medeiros F, Wang X, Araujo AR, Erickson-Johnson MR, Lima JF, Meuter A, Winterhoff B, Oliveira AM. HMGA gene rearrangement is a recurrent somatic alteration in polypoid endometriosis. Hum Pathol. 2012;43(8):1243–8. Hansen K, Simon RA, Lawrence WD, Quddus MR. Unilateral pelvic mass presenting in postmenopausal patients: report of two unusual cases. Ann Diagn Pathol. 2012;16(4):298–301. Dadhwal V, Deka D, Mathur S, Kaushal S, Sharma AK, Mittal S. Vaginal polypoid endometriosis simulating neoplasia in a young woman. J Low Genit Tract Dis. 2012;16(3):318–21. Lambrechts S, Van Calsteren K, Capoen A, Op De Beeck K, Joniau S, Timmerman D, Amant F. Polypoid endometriosis of the bladder during pregnancy mimicking urachal carcinoma. Ultrasound Obstet Gynecol. 2011;38(4):475–8. Syrcle SM, Pelch KE, Schroder AL, Nichols BM, Mills MP, Barrier BF, Havey AD, Nagel SC. Altered gene expression profile in vaginal polypoid endometriosis resembles peritoneal endometriosis and is consistent with increased local estrogen production. Gynecol Obstet Invest. 2011;71(2):77–86. Kwek JW, H'Ng MW, Chew SH, Tay EH. Florid polypoid endometriosis of the cervix with left ureteric obstruction: a mimic of cervical malignancy. Ultrasound Obstet Gynecol. 2010;36(2):252–4. Félix A, Nogales FF, Arias-Stella J. Polypoid endometriosis of the uterine cervix with Arias-Stella reaction in a patient taking phytoestrogens. Int J Gynecol Pathol. 2010;29(2):185–8. Kondo T. Ureteral polypoid endometriosis causing hydroureteronephrosis. Indian J Pathol Microbiol. 2009;52(2):246–8. Marugami N, Hirohashi S, Kitano S, Takahama J, Ito T, Torimoto K, Hirao Y, Kichikawa K. Polypoid endometriosis of the ureter mimicking fibroepithelial polyps. Radiat Med. 2008;26(1):42–5. Kraft JK, Hughes T. Polypoid endometriosis and other benign gynaecological complications associated with Tamoxifen therapy-a case to illustrate features on magnetic resonance imaging. Clin Radiol. 2006;61(2):198–201. Laird LA, Hoffman JS, Omrani A. Multifocal polypoid endometriosis presenting as huge pelvic masses causing deep vein thrombosis. Arch Pathol Lab Med. 2004;128(5):561–4. Chang CK, Chen P, Leu FJ, Lou SM. Florid polypoid endometriosis exacerbated by tamoxifen therapy in breast cancer. Obstet Gynecol. 2003;102(5 Pt 2):1127–30. Schlesinger C, Silverberg SG. Tamoxifen-associated polyps (basalomas) arising in multiple endometriotic foci: A case report and review of the literature. Gynecol Oncol. 1999;73(2):305–11. Grouls V, Berndt R. Endometrioid adenoma (polypoid endometriosis) of the omentum maius. Pathol Res Pract. 1995;191(10):1049–52. Tables Table 1 Clinical features of PEM and endometriosis malignant transformation in the present study. Item Polypoid Endometriosis Endometriosis Malignant Transformation P value Age (yr) 40.7 ± 7.3 47.1 ± 7.1 <0.001* Age at menarche (yr) 14.2 ± 1.5 14.8 ± 1.5 0.221 Number of pregnancies 2.4 ± 1.3 1.9 ± 1.1 0.113 Number of deliveries 1.0 ± 0.5 0.9 ± 0.4 0.512 Percentage of menopause 3.6% 34.1% 0.002* Dysmenorrhea 64.3% 20.5% <0.001* Previous endometriosis 21.4% 20.5% 0.921 Previous adenomyosis 35.7% 2.3% <0.001* Infertility 14.3% 4.5% 0.308 Cesarean section 32.1% 38.6% 0.576 Miscarriage 75.0% 59.1% 0.167 Maximum tumor diameter (cm) 5.3 (3.1, 7.9) 9.4 (6.6, 11.8) <0.001* CA125 92.1 (48.4, 360.9) 31.2 (18.7, 58.2) <0.001* HE4 47.5 (38.8, 52.6) 60.4 (51.1, 75.4) 0.065 Resistance index (RI) 0.5 (0.5, 0.7) 0.5 (0.4, 0.6) 0.235 Recurrence 11.1% 5.1% 0.667 Location Ovary 64.3% 88.6% 0.013* Pelvic cavity 35.7% 11.4% Total 28 44 NOTE: *<0.05. Table 2 Clinical features of PEM and endometriosis malignant transformation cases in the present study. Item Case No. Age (yr) Clinical Presentation Site CA125 (U/ml) Hormonal therapy Surgery Follow-up PEM 1 30 Pelvic mass, Abdominal pain Right ovary 737.9 none Ovarian cystectomy, Mass resection NED 2 35 Pelvic mass, Abdominal pain Rectum 501.1 none Mass resection NED 3 46 Pelvic mass Right ovary 447.2 none BSO, Mass resection NED 4 42 Abdominal pain Right ovary 389.5 none Right SO, Mass resection NED 5 45 Abdominal pain Rectum, Sacral ligament 383.4 Mifepristone TAH, left SO, Right salpingectomy NED 6 37 Pelvic mass Left ovary 364.5 none Bilateral ovarian cystectomy, Mass resection NED 7 41 Dysmenorrhea Uterosacral ligament, Lesions of adenomyosis 350.2 none Bilateral ovarian cystectomy NED 8 37 Pelvic mass Right ovary 285.5 Mifepristone Right ovarian cyst removal Relapse 9 39 Dysmenorrhea Abdominal incision 263 Dydrogesterone TAH, BSO, Mass resection NED 10 36 Pelvic mass Left ovary 254.7 none Bilateral ovarian cystectomy NED 11 48 Vaginal bleeding Left ovary 217 none Left ovarian cystectomy NED 12 48 Pelvic mass Left ovary 127 none Left ovarian cystectomy NED 13 30 Pelvic mass Uterosacral ligament 122.5 none Ovarian cystectomy, Mass resection NED 14 48 Dysmenorrhea, Pelvic mass Posterior fornix of vagina 92.1 none SO, Mass resection NED 15 35 Pelvic mass Posterior fornix of vagina 84 none Left SO, Mass resection NED 16 35 Pelvic mass Rectum 82.3 none Bilateral ovarian cystectomy, Mass resection Relapse 17 33 Pelvic mass Bilateral ovary 69.8 none Ovarian cystectomy, Mass resection NED 18 42 Pelvic mass Posterior fornix of vagina 61.5 none Right ovarian cystectomy, Mass resection Relapse 19 39 Vaginal bleeding, Dysmenorrhea Bilateral ovary 57.8 none Ovarian cyst removal NED 20 48 Dysmenorrhea, Abdominal pain Left ovary 51.1 none TAH, Left SO & Right oophorectomy NED 21 34 Abdominal pain, Ovarian mass Right ovary 48.4 Dydrogesterone Right ovarian cystectomy, Right salpingectomy NED 22 45 Dysmenorrhea Right ovary 45 none BSO, Bilateral ovarian cystectomy NED 23 43 Pelvic mass Right ovary 41.8 none Ovarian cyst removal, myomectomy of broad ligament NED 24 37 Dysmenorrhea Uterosacral ligament, Myometrium 39.3 none Myomectomy NED 25 40 Pelvic mass, Left abdominal pain Bilateral ovary 36 none BSO, Mass resection Developed LG-ESS 26 63 Vaginal bleeding Left ovary 35.5 none BSO / 27 50 Pelvic mass Left ovary 9 none BSO NED 28 33 Pelvic mass Right ovary none none Ovarian cystectomy NED Endometriosis malignant transformation 1 56 Pelvic mass Left ovary 562.2 none Trans abdominal radical surgery Relapse ovary cancer 12 months later 2 38 Dysmenorrhe, Pelvic mass Left ovary 240.4 none Trans abdominal radical surgery NED 3 48 Dysmenorrhe, Pelvic mass Posterior fornix of vagina 200.8 none Trans abdominal radical surgery NED 4 44 Pelvic mass Left ovary 171.6 none Trans abdominal radical surgery NED 5 41 Vaginal bleeding Right ovary 86 none Trans abdominal radical surgery NED 6 49 Dysmenorrhea, Pelvic mass Left ovary 69.9 none Trans abdominal radical surgery NED 7 49 Dysmenorrhea Left ovary 68.1 none Trans abdominal radical surgery NED 8 45 Pelvic mass Left ovary 64.8 none Laparoscopic radical surgery NED 9 48 Abdominal pain Right ovary 58.6 none Trans abdominal radical surgery NED 10 55 Vaginal bleeding Intramural space of uterus 58.5 none Laparoscopic radical surgery NED 11 48 Pelvic mass, Abdominal pain Left ovary 57.3 none Trans abdominal radical surgery NED 12 45 Pelvic mass Left ovary 54.4 none Trans abdominal radical surgery NED 13 40 Pelvic mass Right ovary 47.5 none Trans abdominal radical surgery NED 14 47 Pelvic mass Left ovary 43 none Laparoscopic radical surgery NED 15 52 Pelvic mass Right ovary 42.8 none Trans abdominal radical surgery NED 16 34 Pelvic mass Right ovary 38.3 none Laparoscopic radical surgery NED 17 47 Pelvic mass Right ovary 34.9 none Trans abdominal radical surgery Relapse ovary cancer 10 months later 18 41 Pelvic mass Right ovary 33.5 none Laparoscopic radical surgery NED 19 39 Pelvic mass, Abdominal pain Right ovary 32.2 none Laparoscopic radical surgery NED 20 53 Pelvic mass Left ovary 31.3 none Trans abdominal radical surgery NED 21 52 Pelvic mass Left ovary 31 none Trans abdominal radical surgery NED 22 51 Pelvic mass Right ovary 28 none Trans abdominal radical surgery NED 23 55 Pelvic mass Right ovary 26.5 none Trans abdominal radical surgery NED 24 53 Pelvic mass Left ovary 25.8 none Trans abdominal radical surgery NED 25 42 Pelvic mass Abdominal lesions 23.6 NA Trans abdominal radical surgery NED 26 50 Pelvic mass Left ovary 23 none Trans abdominal radical surgery NED 27 48 Pelvic mass Left ovary 22.8 none Trans abdominal radical surgery NED 28 44 Pelvic mass Right ovary 22.6 none Trans abdominal radical surgery NED 29 48 Pelvic mass Left ovary 20.5 none Trans abdominal radical surgery NED 30 38 Vaginal bleeding Posterior fornix of vagina 19.7 NA Laparoscopic radical surgery NED 31 51 Pelvic mass Right ovary 18.3 none Trans abdominal radical surgery NED 32 41 Pelvic mass Right ovary 18.1 none Trans abdominal radical surgery NED 33 29 Pelvic mass Left ovary 14.6 none Laparoscopic radical surgery NED 34 55 Pelvic mass Left ovary 13.5 none Trans abdominal radical surgery NED 35 33 Dysmenorrhea Right ovary 13.2 none Trans abdominal radical surgery NED 36 58 Pelvic mass Left ovary 12.7 none Trans abdominal radical surgery NED 37 51 Pelvic mass Left ovary 12 none Trans abdominal radical surgery NED 38 56 Pelvic mass Rectum 11.9 none Trans abdominal radical surgery NED 39 51 Vaginal bleeding Right ovary 11.2 none Trans abdominal radical surgery NED 40 49 Pelvic mass Right ovary 10.4 none Laparoscopic radical surgery NED 41 56 Pelvic mass Left ovary none none Laparoscopic radical surgery NED 42 57 Pelvic mass Left ovary none none Laparoscopic radical surgery NED 43 35 Pelvic mass Left ovary none NA Trans abdominal radical surgery NED 44 52 Pelvic mass Right ovary none none Mass removal NED Note: BSO, bilateral salpingo-oophorectomy; NA, not available; LN, lymph node; NED, no evidence of disease; SO, salpingo-oophorectomy; TAH, total Abdominal hysterectomy. Table 3 Clinical features of published PEM cases Author (Year) Case No. Age (yr) Clinical Presentation Site CA125 (U/ml) History of hormonal therapy Surgery Follow-up Parker (2004)[2] 1 23 Pelvic mass, Abdominal pain Peritoneum NA NA Aspiration of cyst contents, Partial excision, Left ovarian cystectomy NA 2 34 Pelvic mass Retroperitoneum NA HRT Mass resection, Sigmoid colectomy NED 3 39 Pelvic mass Colon, Uretus, Left Fallopian tube, Left broad ligament NA NA Sigmoid resection, Resection of endometriomas, Myomectomies NED 4 40 Bowel obstruction Colon NA NA Oophorectomy, Colonic resection DOC 5 40 Vaginal polyp, Pelvic mass Vagina NA HRT Polypectomies NED 6 43 Pelvic mass Left ovary NA TAH, BSO NA 7 43 Pelvic mass Ptritoneum NA HRT Mass resection, Ureterectomy NED 8 45 Vaginal bleeding Vagina NA NA Vaginal vault curettings NED 9 46 Abdominal pain Colon NA NA Sigmoid resection NED 10 52 Frequent urination, Pelvic mass Right Ovary NA HR BSO Recent 11 53 Pelvic mass Colon, Para-vagina, Omentum NA HRT Excision of pelvic masses, Cecal resection, Upper vaginectomy, Omentectomy NED 12 55 Vaginal bleeding Right ureter, Vagina NA Unopposed estrogen Mass resection, Ureterectomy NA 13 55 Right adnexal mass Uterus NA NA TAH, BSO NA 14 56 Hematuria, Hydronephrosis Ureter NA HRT Resection of distal right ureter NED 15 57 Postmenopausal bleeding, Vaginal mass, Abdominal pain Vagina, Cervix, Rectum, Ureter NA NA TAH, BSO, Partial resection of rectum & ureter NED 16 59 Postmenopausal bleeding Right ovary NA HRT TAH, BSO NED 17 60 Abdominal pain, Ovarian mass Ovary NA HRT TAH, BSO NED 18 62 Left adnexal mass Left ovary NA HRT TAH, BSO NED 19 63 Postmenopausal bleeding Ovary, Fallopian tube NA none BSO NED 20 64 none Uterus NA NA TAH, BSO NED 21 67 Pelvic mass, Colonic stricture Colonic mesentery NA NA Peritoneal biopsies, Partial colonic resection, Oophorectomy NED 22 74 Right adrenal mass Periadorenal tissue, Omentum NA Unopposed estrogen Mass resection NED 23 78 Pelvic mass Peritoneum NA NA Partial excision of mass NA 24 NA Bowel obstruction Colon NA NA Colonic resection NA Miyoshi (2022)[13] 25 32 Pelvic mass Anterior wall of the uterus NA NA Partial excision of mass NED 26 35 Pelvic mass Right Ovary 340 NA SO Relapse 27 39 Dysmenorrhea, Lower abdominal tumor Right adnexa NA NA Right SO NED Jacquot (2021)[14] 28 43 Pelvic pain, Longstanding dyspareunia Douglas pouch NA NA Abdominal radical colpohysterectomy with SO and ovarian transposition NED Ling (2020)[15] 29 20 Dysmenorrhea Left ovary 58.72 NA Abdominal surgery Relapse Ghafoor (2020)[16] 30 60 Pelvic mass cul-de-sac posterior to the cervical remnant <35 HRT Abdominal surgery NED Carbone (2020)[12] 31 53 Recurrent pelvis mass Left ovary 476 NA Total pelvic exenteration NED Tsai (2019)[17] 32 23 Lower abdominal pain Douglas pouch 1317 NA Mass resection NED Tabakin (2018)[18] 33 41 Left back pain, Hematuria Left kidney NA NA Left radical nephrectomy NED Ramai (2018)[19] 34 48 Constipation, Lower gastrointestinal bleeding Sigmoid colon NA NA Sigmoid colectomy NA Laopakorn (2018)[20] 35 47 Urinary urgency Urinary bladder, Left ovary NA NA SO, Resection of left sacrouterine ligament & bladder tumor NED Zhuang (2017)[21] 36 62 Hematouria Ureter NA Oral contraceptive Ureterectomy, Partial cystectomy NED Jaegle (2017)[10] 37 62 Hematuria Ovary, Endometrium 37.6 Tamoxifen Posterior pelvic exentration NED Iida (2017)[22] 38 44 Swelling in the lower abdomen Ovary 261 none TAH, BSO, Omentectomy, Left pelvic lymphadenectomy, Right pelvic lymph node biopsy NA Han (2017)[23] 39 58 Diarrhea, Postmenopausal bleeding Rectum-sigmoid colon NA NA Removal of the rectosigmoid mass, Proctosigmoidectomy, ileostomy, TAH, BSO NA Yamamoto (2016)[24] 40 37 none Ovary 3263 Various hormonal therapy TAH, BSO, Partial omentectomy NA Tham (2016)[25] 41 43 Dysmenorrhea Cervix NA none Hysteroscopy with dilation and curettage NA Takeuchi (2016)[26] 42 52 Irregular menstruation Uterus-Douglas pouch 123 none TAH, BSO, Mass resection, Intrapelvic lymph node dissection NA Kim (2015) [27] 43 30 Dysmenorrhea Ovary 595.3 NA SO NED Gunawardane (2015)[28] 44 50 Lower abdominal pain Douglas pouch NA HRT Biopsy NED Gezer (2015)[29] 45 25 none Pouch of Douglas 86.6 NA Abdominal surgery NA Choi (2015)[30] 46 66 none Ovary NA Tamoxifen TAH, BSO NA Yamada (2014)[31] 47 29 Dysmenorrhea Ovary 121.9 NA SO NED Jaiman (2014)[32] 48 29 Vaginal mass with discharge, Menorrhagia Cervix NA none Polypectomy NA Koyama (2013)[33] 49 38 Vaginal bleeding, Lower abdominal Pain Ovary NA NA Tumor resection, Uterine repair NA Kozawa (2012)[34] 50 36 Lower abdominal pain Right ovary 323 none Right SO NA Medeiros (2012)[35] 51 22 Abdominal pain, Rectal bleeding Jejunum, Peritoneum NA NA TAH, BSO, Mass resection NA 52 46 Uretheral obstruction Ureter NA NA TAH, BSO Recurrence after 8 years 53 NA NA NA NA NA NA Hansen (2012)[36] 54 57 Abdominal fullness Right ovary <35 NA Mass resection NED 55 81 Postmenopausal bleeding, Abdominal fullness Endometrium, Right ovary NA NA Staging laparotomy NED Dadhwal (2012)[37] 56 27 Lower abdominal pain, Menorrhagia, Vaginal bleeding Vagina, Uterus, Parametrium, Peritoneum NA NA BSO NED Lambrechts (2011)[38] 57 29 Hematuria Urachus NA NA Mass resection NED Syecle (2011)[39] 58 25 Dysmenorrhea, Dyspareunia, Pelvic pain Vagina, Cervix NA Depo-provera Polypectomy NA Kwek (2010)[40] 59 48 Vaginal bleeding Left parametrium, Sigmoid colon, Ureter, Bladder NA NA Exploratory laparotomy NA Felix (2010)[41] 60 48 Postcoital bleeding Cervix NA Unopposed estrogen TAH, BSO NED Kondo (2009)[42] 61 44 Lower back pain Ureter NA NA Partial resection of the ureter NED Takeuchi (2008)[11] 62 44 Lower abdominal Pain, Vaginal bleeding Douglas pouch 89 none TAH, Left SO, Mass resection NA Marugami (2008)[43] 63 45 Lower abdominal pain Ureter 395 GnRH agonist Transurethral resection NA Kraft (2006)[44] 64 47 Pelvic pain, Dysmenorrhea Left ovary, Douglas pouch 817 Tamoxifen TAH, BSO NA Laird (2004)[45] 65 80 Abdominal mass, Vaginal bleeding Uterus, Left ovary 323 NA TAH, BSO, Mass resection NED Chang (2003)[46] 66 NA Vaginal bleeding Endometrium, Douglas pouch 138.86 Tamoxifen TAH, BSO, Sigmoid resection NED Schlesinger (1999)[47] 67 62 Vaginal bleeding Endometrium NA Tamoxifen Biopsy Endometrial cancer 8 months later Othman (1996)[9] 68 30 Dysmenorrhea Douglas pouch, Ovary, Omentum NA NA Polypectomy NA Grouls (1995)[48] 69 89 Gastro-intestinal bleeding Omentum NA NA Mass resection NA Note: BSO, bilateral salpingo-oophorectomy; DOC, dead from other causes; GnRH, gonadotropin releasing hormone; HRT, hormone replacement therapy; NA, not available; LN, lymph node; NED, no evidence of disease; SO, salpingo-oophorectomy; TAH, total Abdominal hysterectomy. 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Because of its rare incidence and non-specific presentation, the diagnosis of PEM is commonly delayed or missed. Due to the morphological features it is difficult to distinguish malignant tumor from PEM preoperatively[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Therefore, it often brings a heavy psychological burden to the patients and their families. Since it is so difficult to distinguish PEM from malignancy preoperatively most patients undergo a hysterectomy which can have devastating consequences for young women of childbearing age if they desire future fertility. It is known that the current understanding of PEM is far from complete. To date, publications on PEM have been limited, and only one report with a large set of cases (24 patients) has been clinicopathologically analyzed[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this study, we conduct a relatively large retrospective analysis focused on the clinicopathological features and outcome of PEMs to provide a useful reference for the diagnosis and treatment of such tumors.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePatients and samples\u003c/h2\u003e \u003cp\u003ePatients with a final diagnosis of PEM (n\u0026thinsp;=\u0026thinsp;28) and endometriosis with malignant transformation (n\u0026thinsp;=\u0026thinsp;44) were identified in our hospital from January 2011 to December 2021. Hematoxylin and eosin (H\u0026amp;E) and immunohistochemical (IHC) staining slides were reviewed by 2 gynecologic pathologists in a blinded fashion and the pathologic diagnosis was confirmed. All related clinical data were extracted from the electronic clinical information system database. The normal upper limitation of serum CA125 was defined as 35U/ml. This study was approved by the Ethics Committee of the Women's Hospital, School of medicine, Zhejiang University (NO: IRB-20220349-R).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe software program SPSS, version 26.0 (IBM, Armonk, NY, USA), was used for statistical analysis. Before performing specific statistical tests, we performed tests for normality and homogeneity of variance. Means\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (χ- \u0026plusmn; s) or median (inter-quartile range) for normal and non-normally distributed data, respectively. Statistical comparisons between groups were made using t-test or non-parametric test. Categorical variables, expressed as percentages, were evaluated using the chi-square test or Fisher's exact test. P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e1. Clinicopathological features of patients\u003c/h2\u003e \u003cp\u003eAmong the 28 PEM cases, 18/28 (64.3%) the most common location was ovarian, followed by posterior vaginal fornix (3/28, 10.7%), rectum (3/28, 10.7%), uterosacral ligament (3/28, 10.7%), and abdominal incision (1/28, 3.6%). In terms of surgical treatment 13/28 patients (46.4%) underwent ovarian cyst removal, 6/28 (21.4%) underwent bilateral salpingo-oophorectomy (BSO), 4/28 (14.3%) total abdominal hysterectomy (TAH) along with BSO, 2/28 (7.1%) TAH along with ovarian cyst removal, 1/28 (3.6%) had only mass removal, 1/28 (3.6%) myomectomy, and 1/28 (3.6%) myomectomy of broad ligament.\u003c/p\u003e \u003cp\u003eAmong the 44 endometriosis with malignant transformation cases, 39/44 (88.6%) were located at the ovary, followed by rectum (2/44, 4.5%), posterior vaginal fornix (1/44, 2.3%), intramural space of uterus (1/44, 2.3%) and abdominal incision (1/44, 2.3%). 32/44 (70.5%) patients received trans abdominal radical surgery (TAH\u0026thinsp;+\u0026thinsp;BSO\u0026thinsp;+\u0026thinsp;pelvic and paraaortic lymphadenectomy\u0026thinsp;+\u0026thinsp;omentectomy), 11/44 (25%) patients received laparoscopic radical surgery, and 1/44 (2.3%) received mass removal. Detailed analysis is shown in table1, 2.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2. Clinical features of PEM and compared to endometriosis malignant transformation\u003c/h2\u003e \u003cp\u003ePatients in the PEM group were 30 to 63 years old (mean 40.7 years). Of the 28 patients, 6/28 (21.4%) had a history of endometriosis, 10/28 (35.7%) had a history of adenomyosis, 18/28 (64.3%) had dysmenorrhea, and 4/28 (14.3%) were diagnosed with female infertility. Human epididymis secretion protein 4 (HE4) was 47.5 U/mL (IQR, 38.8\u0026ndash;52.6). The median maximum tumor diameter was of 5.3 cm, with a maximum of 26.4 cm.\u003c/p\u003e \u003cp\u003eCompared with the malignant endometriosis group, patients in the PEM group were younger (40.7\u0026thinsp;\u0026plusmn;\u0026thinsp;7.3 vs. 47.1\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and thus the percentage of postmenopausal women was lower (3.6% vs. 34.1%, P\u0026thinsp;=\u0026thinsp;0.002). Dysmenorrhea was significantly more common in the PEM group as compared to the malignant endometriosis group (64.3% vs. 20.5%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The incidence of adenomyosis was also much higher in the PEM group (35.7% vs. 2.3%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and the median maximum tumor diameter was smaller [5.3 (IQR, 3.1\u0026ndash;8.0) vs. 9.4 (IQR, 6.6\u0026ndash;11.8), P\u0026thinsp;\u0026lt;\u0026thinsp;0.001].\u003c/p\u003e \u003cp\u003eIn addition, we compared the serum level of CA125 between patients with PEM and endometriosis with malignant transformation. For the PEM group, the serum levels of CA125 were available in 27 cases, 21/27 (77.8%) showed elevated levels of CA125. Interestingly, in the malignant endometriosis group 40 cases had serum CA125 levels available and only 13/40 (32.5%) had elevated levels of CA125. The median value of CA125 was 92.1 U/mL (IQR, 48.4\u0026ndash;360.9) in the PEM group, which was higher than that in the malignant endometriosis group [92.1 (IQR, 48.4\u0026ndash;360.9) vs. 31.2 (IQR, 18.7\u0026ndash;58.2), P\u0026thinsp;\u0026lt;\u0026thinsp;0.001]. Detailed analysis is shown in table 1, 2.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3. Follow-up of PEM and endometriosis with malignant transformation\u003c/h2\u003e \u003cp\u003eIn total 27 PEM and 39 endometriosis with malignant transformation patients had complete follow-up information available. Median follow-up time for both groups was 49.0 months (IQR, 14.75\u0026ndash;78.5). In PEM cases, 23/27 (85.2%) survived without recurrence, 3/27 (11.1%) survived with radiographic recurrence, 1/27 (3.7%) survived but was found to have endometriosis with malignant transformation of low-grade endometrial stromal sarcoma (LG-ESS). In the endometriosis with malignant transformation cases, 37/39 (94.9%) survived without recurrence, 2/39 (5.1%) developed recurrence. Detailed analysis is shown in table 1, 2.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003ePEM\u0026nbsp;is rare, most often found incidentally, and has a risk of malignant transformation. However,\u0026nbsp;there are very few cases and clinicopathologic reports, making it difficult to provide consensus or guidelines for clinical practice. Thus, we explore the clinicopathological features and outcome of PEMs to provide important information for the correct diagnosis of PEM.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLiterature Review\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA literature review was conducted in this report by searching PubMed between 1990 and 2022 using the keyword \u0026ldquo;polypoid endometriosis\u0026rdquo;. This search yielded 69 PEM\u0026nbsp;cases (Table 3).\u0026nbsp;The average age was 47.5 years, and 30 of them were younger than 45\u0026thinsp;years old. With in the 69 cases reviewed\u0026nbsp;there were no typical symptoms of PEM, 13 presented with\u0026nbsp;abdominal\u0026nbsp;or back pain, 13 had a pelvis mass, 8 had abnormal vaginal bleeding, and 8 had dysmenorrhea. In addition, serum CA 125 levels were available for 19 of the PEM cases. 17 of those cases had elevated serum CA 125 levels. Preoperative hormone therapy is a possible diagnostic treatment option for PEM. In the literature review, 22 patients had a history of hormonal therapies (including hormone replacement therapy, Tamoxifen, and oral contraception), which, in a sense, supports that PEM is an estrogen-dependent tumor. Thirty-seven of the 69 cases were followed up with no evidence of disease,\u0026nbsp;3\u0026nbsp;cases survived with radiographic recurrence, and 1 case developed endometrial cancer eight months after surgery. The rest were lost to follow up. These findings indicate that PEM has a propensity for local recurrence and a low risk of malignant transformation. The potential for malignant transformation of PEM has been cited as an indication for surgical resection, even in asymptomatic patients[3].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSummary of Main Results in the Present Study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe clinical\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003emanifestations of the 28 cases of PEM and 44 cases of\u0026nbsp;endometriosis with malignant transformation\u0026nbsp;are summarized in Table1, 2.\u0026nbsp;Compared with patients in the endometriosis with malignant transformation group, patients in the PEM group were younger, mainly of childbearing age and a lower percentage of postmenopausal patients. The PEM patients had a higher percentage of dysmenorrhea, a smaller maximum tumor diameter, and a higher CA125 level.\u0026nbsp;In\u0026nbsp;the 28 PEM group, most were of childbearing age at the time of diagnosis, and no association with premenopausal women was found.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eIn contrast Parker et al.[2]\u003csup\u003e\u0026nbsp;\u003c/sup\u003esuggested that PEM often occurred in post-menopausal women as 60%\u0026nbsp;of the patients in that study\u0026nbsp;were over 50. This difference may be due to the fact that the majority of the cases reported in the literature were consultation cases, which is related to selection bias. Moreover,\u0026nbsp;ethnicity may be another possible reason.\u003c/p\u003e\n\u003cp\u003eMost of the patients in this study had no typical presenting symptoms, and the pelvic tumors were discovered incidentally by pelvic ultrasonography during routine pelvic exams. Some PEM patients had irregular vaginal bleeding with or without\u0026nbsp;abdominal\u0026nbsp;pain. Endometriosis is a common condition among women of reproductive age and is a leading cause of infertility, affecting more than 10% of women of reproductive age for unknown reasons[4, 5]. As a unique form of endometriosis, PEM might\u0026nbsp;affect fertility. In our patient cohort 14.3% of the 28 PEM patients were diagnosed with infertility and none became pregnant during the follow-up period, although it is not known what percent of these patients were attempting pregnancy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCA125, a well-established marker for epithelial cell ovarian cancer, is derived from coelomic epithelia including the endometrium, fallopian tube, ovary, and peritoneum[6]. In our study,\u0026nbsp;patients in PEM group showed higher median value of CA125 than the endometriosis malignant group. Kadan et al.[7]\u0026nbsp;suggested that erroneously elevate CA125 levels in patients with endometriosis make the differentiation between benign and malignant cysts challenging for gynecologists. Therefore, the level of CA125 lacks specificity in diagnosing malignant transformation of endometriosis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults in the Context of Published Literature\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe exact pathogenesis of PEM is still unclear, and medical history provides essential information for the correct diagnosis. In the studies reviewed nearly 50% of patients with PEM in the literature were reported to receive hormonal treatment (either unopposed estrogen or mixed estrogen-progestin therapy) at the time of diagnosis[8]. Othman et al.[9]\u0026nbsp;reported a case of PEM in a woman with recurrent endometriosis following GnRH agonist withdrawal and postulated that the lesion was a rebound phenomenon upon withdrawal of GnRH agonist-induced hormonal suppression. In another reported case, a 62-year-old woman who took tamoxifen for two years following partial mastectomy for breast cancer developed multiple \u0026ldquo;endometriotic polyps\u0026rdquo; on the cervical serosa and both ovaries[10]. However,\u0026nbsp;only 4/28 patients in this study had any lifetime use of hormonal\u0026nbsp;therapy since oral contraceptives are not widely used in China. Therefore, there is insufficient evidence for a causal link between hormonal treatment and PEM.\u003c/p\u003e\n\u003cp\u003eRecurrence rates after surgical treatment of endometriosis vary widely in the literature. The mean recurrence rate of endometriosis is estimated to be around 20% at the 2\u003csup\u003end\u003c/sup\u003e year of follow-up and up to 50% at 5\u003csup\u003eth\u003c/sup\u003e year[8]. During the follow-up of the present study, there were 3 cases of radiographic recurrence with a recurrence rate of 11.1%\u0026nbsp;at 4\u003csup\u003eth\u003c/sup\u003e year.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere are few reports on the malignant transformation of PEM in the current literature. Takeuchi\u0026nbsp;et al.[11]\u0026nbsp;reported a case of PEM with malignant transformation: a 52-year-old woman (gravida 2, para 2) who had not received hormone therapy and was surgically confirmed to have atypical endometrial hyperplasia with well-differentiated endometrioid carcinoma which was considered as the malignant transformation of PEM. Carbone et al.[12]\u0026nbsp;reported on a 53-year-old nulliparous woman who had been treated for over 10 years for recurrent and symptomatic pelvic PEM and underwent four surgical resections during that time. The pathology from her last resection showed a rare myxoid low-grade endometrial stromal sarcoma (ESS) that had arisen with in the PEM. Similarly, in our study there was one patient, a 42-year-old woman (gravida 2, para 1) who had not received any hormonal treatment or Tamoxifen, that developed low-grade endometrial stromal sarcoma after PEM.\u003c/p\u003e\n\u003cp\u003eIn our study as well as in previous literature, PEM manifests as a polypoid mass within an ovarian endometrioma, mimicking ovarian cancer, or as discrete lesions in the pelvic cavity protruding to adjacent structures simulating peritoneal dissemination or malignant tumors[11].\u0026nbsp;Macroscopically, nodules are various shades of white-gray, pink-red, or yellow-brown, and usually softer than malignant tumors.\u0026nbsp;Microscopically, polypoid lesions are covered by monolayered columnar to cuboidal epithelial cells on the surface and have a dense cellular stroma under the epithelial layer.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and Weaknesses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo our knowledge, this is\u0026nbsp;the\u0026nbsp;largest clinicopathologic analysis and literature review of PEM.\u0026nbsp;It is also the first study to compare PEM and endometriosis with malignant transformation to help clinicians differentiate between the two and improve the accuracy of preoperative diagnosis. As this study was a relatively small retrospective study from a single institution, the possibility of confounding variables cannot be entirely excluded.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplications for Practice and Future\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThese results should be further validated through larger, multi-institutional studies. Further work is required to establish better examination and find more typical clinical manifestation for accurate diagnosis and appropriate treatment in clinical practice.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePEM is a benign lesion with rare incidence and non-specific presentation, diagnosis might be delayed or missed. Patients with PEM often have dysmenorrhea, history of adenomyosis, pelvic masses and elevated serum CA125. Our study shows patients with PEM have a low risk for malignant transformation. Due to the lack of specific clinical features and laboratory tests, preoperative diagnosis of PEM is difficult. The patient\u0026rsquo;s medical history and laboratory tests provide important information for the correct diagnosis for PEM.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePEM:\u003c/em\u003e\u003c/strong\u003e\u0026nbsp; Polypoid endometriosis\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eESS:\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e Endometrial stromal sarcoma\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCA125:\u003c/em\u003e\u003c/strong\u003e\u0026nbsp; Cancer antigen 125\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eH\u0026amp;E:\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e Hematoxylin and eosin\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eIHC:\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e Immunohistochemical\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eIQR:\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e Inter-quartile range\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eBSO:\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e Bilateral salpingo-oophorectomy\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTAH:\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e Total abdominal hysterectomy\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eHE4:\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e Human epididymis secretion protein 4\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eLG-ESS:\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e Low-grade endometrial stromal sarcoma\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll procedures performed in studies involving human participants were following the ethical standards of the national and/or national research committee and with the Helsinki declaration. Informed consent was obtained from all subjects and/or their legal guardian(s). The study was approved by the Institutional Review Board at Zhejiang University School of Medicine Women\u0026rsquo;s Hospital, China (NO: IRB-20220349-R). All data were anonymized to maintain patient privacy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors report no conflicts of interest in this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo specific funding was disclosed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQQ. X and YL designed the study; QQ. X, CK. Z and FZ recruited the patients and collected patient material; QQ. X and LH. L performed the statistical analysis. YL, FZ, Elaine F and HC drafted the manuscript, and all authors critically reviewed and revised the manuscript. FZ is the guarantor of this work and as such had full access to all data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All researchers listed as authors are independent from the funders, and all final decisions about the research were made without constraint by the investigators.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMostoufizadeh M, Scully RE. Malignant tumors arising in endometriosis. Clin Obstet Gynecol. 1980;23(3):951\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParker RLMD, Farnaz MD, Young, Robert HMD, Clement PBMD. Polypoid Endometriosis: A Clinicopathologic Analysis of 24 Cases and a Review of the Literature. Am J Surg Pathol 2004.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlborzi S, Zarei A, Alborzi S, Alborzi M. Management of ovarian endometrioma. Clin Obstet Gynecol. 2006;49(3):480\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTan Z, Hung SW, Zheng X, Wang CC, Chung JP, Zhang T. What We Have Learned from Animal Models to Understand the Etiology and Pathology of Endometrioma-Related Infertility. Biomedicines 2022, 10(7).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGupta S, Goldberg JM, Aziz N, Goldberg E, Krajcir N, Agarwal A. Pathogenic mechanisms in endometriosis-associated infertility. Fertil Steril. 2008;90(2):247\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJacobs I. Screening for ovarian cancer by CA-125 measurement. Lancet. 1988;1(8590):889.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKadan Y, Fiascone S, McCourt C, Raker C, Granai CO, Steinhoff M, Moore RG. Predictive factors for the presence of malignant transformation of pelvic endometriosis. Eur J Obstet Gynecol Reprod Biol. 2015;185:23\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCeccaroni M, Bounous VE, Clarizia R, Mautone D, Mabrouk M. Recurrent endometriosis: a battle against an unknown enemy. Eur J Contracept Reprod Health Care. 2019;24(6):464\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOthman NH, Othman MS, Ismail AN, Mohammad NZ, Ismail Z. Multiple polypoid endometriosis\u0026ndash;a rare complication following withdrawal of gonadotrophin releasing hormone (GnRH) agonist for severe endometriosis: a case report. Aust N Z J Obstet Gynaecol. 1996;36(2):216\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJaegle WT, Barnett JC, Stralka BR, Chappell NP. Polypoid endometriosis mimicking invasive cancer in an obese, postmenopausal tamoxifen user. Gynecol Oncol Rep. 2017;22:105\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTakeuchi M, Matsuzaki K, Furumoto H, Nishitani H. Case report: A case of polypoid endometriosis: MR pathological correlation. Br J Radiol. 2008;81(964):e118\u0026ndash;119.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCarbone F, Kaur MM, Chok AY, Kontovounisios C, Ind T, Rasheed S. Endometrial stromal sarcoma arising from polypoid endometriosis: Case report and literature review. Int J Surg Case Rep. 2020;72:537\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiyoshi S, Yamaguchi K, Chigusa Y, Sunada M, Yamanoi K, Horie A, Hamanishi J, Kondoh E, Mandai M. Fertility preservation of polypoid endometriosis: Case series and literature review. J Obstet Gynaecol Res. 2022;48(2):502\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJacquot A, Gertych W, Golfier F, Devouassoux-Shisheboran M, Rousset P. Polypoid endometriosis of the Douglas pouch. Radiol Case Rep. 2021;16(3):612\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLing R, Jin H, Yang Y, Cheng L. Polypoid Endometriosis of the Rectum and Vagina in an Adolescent. J Pediatr Adolesc Gynecol. 2020;33(5):581\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGhafoor S, Lakhman Y, Park KJ, Petkovska I. Polypoid endometriosis: a mimic of malignancy. Abdom Radiol (NY). 2020;45(6):1776\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTsai C, Huang SH, Huang CY. Polypoid endometriosis - A rare entity of endometriosis mimicking ovarian cancer. Taiwan J Obstet Gynecol. 2019;58(3):328\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTabakin AL, Dutton JL, Fatima A, Sadimin E, Jang TL. Polypoid Endometriosis Presenting as a Renal Cortical Tumor. Urology. 2018;119:e5\u0026ndash;e7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRamai D, Linn S, Murphy T, Reddy M. Transmural Polypoid Endometriosis of the Sigmoid Colon. J Gastrointest Surg. 2018;22(12):2184\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLaopakorn S, Huang KG. Polypoid Endometriosis of Urinary Bladder. Gynecol Minim Invasive Ther. 2018;7(2):86\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhuang L, Eisinger D, Jaworski R. A case of ureteric polypoid endometriosis presenting in a post-menopausal woman. Pathology. 2017;49(4):441\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIida Y, Tabata J, Yorozu T, Kitai S, Ueda K, Saito M, Yanaihara N, Yamada K, Okamoto A. Polypoid endometriosis of the ovary and m\u0026uuml;llerianosis of pelvic lymph nodes mimicking an ovarian carcinoma with lymph node metastasis. Int Cancer Conf J. 2017;6(4):145\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHan K, Li X, Bhargava R, Taylor S, Lee K, Yadav D. Polypoid Endometriosis Presenting as a Colonic Mass. ACG Case Rep J. 2017;4:e39.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYamamoto A, Usami T, Kondo E, Kato K, Motoyama T. Huge polypoid endometriosis: report of a case and review of the literature. Int Cancer Conf J. 2016;5(1):31\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTham WP, Busmanis I, Tan WC, Kwek JW. Polypoid endometriosis of post vaginal fornix: utility of MRI imaging of pelvis with diffusion weighted imaging for diagnosis. Med J Malaysia. 2016;71(3):144\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTakeuchi M, Matsuzaki K, Bando Y, Nishimura M, Yoneda A, Harada M. A case of polypoid endometriosis with malignant transformation. Abdom Radiol (NY). 2016;41(9):1699\u0026ndash;702.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim JY, Song TJ, Choi HK, Shim JY. Multifocal Polypoid Endometriosis Mimicking Malignancy in a Young Woman with a History of Hormonal Treatment. J Pathol Transl Med. 2015;49(5):418\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGunawardane DN, Allen PW. Selected Case From the Arkadi M. Rywlin International Pathology Slide Club: Polypoid Endometriosis in the Pouch of Douglas in a Perimenopausal Woman. Adv Anat Pathol. 2015;22(5):331\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGezer NS, Se\u0026ccedil;il M, Ulukuş E, Celiloğlu M. Polypoid endometriosis presenting as a mass at the pouch of Douglas. J Obstet Gynaecol. 2015;35(8):861\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChoi IH, Jin SY, Jeen YM, Lee JJ, Kim DW. Tamoxifen-associated polypoid endometriosis mimicking an ovarian neoplasm. Obstet Gynecol Sci. 2015;58(4):327\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYamada Y, Miyamoto T, Horiuchi A, Ohya A, Shiozawa T. Polypoid endometriosis of the ovary mimicking ovarian carcinoma dissemination: a case report and literature review. J Obstet Gynaecol Res. 2014;40(5):1426\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJaiman S, Gundabattula SR, Pochiraju M, Sangireddy JR. Polypoid endometriosis of the cervix: a case report and review of the literature. Arch Gynecol Obstet. 2014;289(4):915\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKoyama S, Kobayashi M, Tanaka Y, Isobe M, Miwa H, Shiki Y. Laparoscopic repair of a post-myomectomy spontaneous uterine perforation accompanied by a bizarre tumor resembling polypoid endometriosis. J Minim Invasive Gynecol. 2013;20(6):912\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKozawa E, Inoue K, Iwasa N, Fujiwara K, Yasuda M, Tanaka J, Kimura F. MR imaging of polypoid endometriosis of the ovary. Magn Reson Med Sci. 2012;11(3):201\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMedeiros F, Wang X, Araujo AR, Erickson-Johnson MR, Lima JF, Meuter A, Winterhoff B, Oliveira AM. HMGA gene rearrangement is a recurrent somatic alteration in polypoid endometriosis. Hum Pathol. 2012;43(8):1243\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHansen K, Simon RA, Lawrence WD, Quddus MR. Unilateral pelvic mass presenting in postmenopausal patients: report of two unusual cases. Ann Diagn Pathol. 2012;16(4):298\u0026ndash;301.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDadhwal V, Deka D, Mathur S, Kaushal S, Sharma AK, Mittal S. Vaginal polypoid endometriosis simulating neoplasia in a young woman. J Low Genit Tract Dis. 2012;16(3):318\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLambrechts S, Van Calsteren K, Capoen A, Op De Beeck K, Joniau S, Timmerman D, Amant F. Polypoid endometriosis of the bladder during pregnancy mimicking urachal carcinoma. Ultrasound Obstet Gynecol. 2011;38(4):475\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSyrcle SM, Pelch KE, Schroder AL, Nichols BM, Mills MP, Barrier BF, Havey AD, Nagel SC. Altered gene expression profile in vaginal polypoid endometriosis resembles peritoneal endometriosis and is consistent with increased local estrogen production. Gynecol Obstet Invest. 2011;71(2):77\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKwek JW, H'Ng MW, Chew SH, Tay EH. Florid polypoid endometriosis of the cervix with left ureteric obstruction: a mimic of cervical malignancy. Ultrasound Obstet Gynecol. 2010;36(2):252\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eF\u0026eacute;lix A, Nogales FF, Arias-Stella J. Polypoid endometriosis of the uterine cervix with Arias-Stella reaction in a patient taking phytoestrogens. Int J Gynecol Pathol. 2010;29(2):185\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKondo T. Ureteral polypoid endometriosis causing hydroureteronephrosis. Indian J Pathol Microbiol. 2009;52(2):246\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarugami N, Hirohashi S, Kitano S, Takahama J, Ito T, Torimoto K, Hirao Y, Kichikawa K. Polypoid endometriosis of the ureter mimicking fibroepithelial polyps. Radiat Med. 2008;26(1):42\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKraft JK, Hughes T. Polypoid endometriosis and other benign gynaecological complications associated with Tamoxifen therapy-a case to illustrate features on magnetic resonance imaging. Clin Radiol. 2006;61(2):198\u0026ndash;201.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLaird LA, Hoffman JS, Omrani A. Multifocal polypoid endometriosis presenting as huge pelvic masses causing deep vein thrombosis. Arch Pathol Lab Med. 2004;128(5):561\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChang CK, Chen P, Leu FJ, Lou SM. Florid polypoid endometriosis exacerbated by tamoxifen therapy in breast cancer. Obstet Gynecol. 2003;102(5 Pt 2):1127\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchlesinger C, Silverberg SG. Tamoxifen-associated polyps (basalomas) arising in multiple endometriotic foci: A case report and review of the literature. Gynecol Oncol. 1999;73(2):305\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGrouls V, Berndt R. Endometrioid adenoma (polypoid endometriosis) of the omentum maius. Pathol Res Pract. 1995;191(10):1049\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1 Clinical features of PEM and endometriosis malignant transformation in the present study.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eItem\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePolypoid Endometriosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eEndometriosis Malignant Transformation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eAge (yr)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40.7 \u0026plusmn; 7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47.1 \u0026plusmn; 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eAge at menarche (yr)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.2 \u0026plusmn; 1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.8 \u0026plusmn; 1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eNumber of pregnancies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.4 \u0026plusmn; 1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.9 \u0026plusmn; 1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.113\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eNumber of deliveries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.0 \u0026plusmn; 0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.9 \u0026plusmn; 0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.512\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003ePercentage of menopause\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e64.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003ePrevious endometriosis\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.921\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003ePrevious adenomyosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eInfertility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.308\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eCesarean section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.576\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eMiscarriage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e75.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e59.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.167\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eMaximum tumor\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ediameter (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.3 (3.1, 7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.4 (6.6, 11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eCA125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e92.1 (48.4, 360.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.2 (18.7, 58.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHE4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47.5 (38.8, 52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60.4 (51.1, 75.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eResistance index (RI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.5 (0.5, 0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.5 (0.4, 0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.235\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eRecurrence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.667\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003eLocation\u003c/p\u003e\u0026nbsp;\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eOvary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e64.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.013*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePelvic cavity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\n \u003cp\u003eNOTE: *\u0026lt;0.05.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"741\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"9\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eClinical features of PEM and endometriosis malignant transformation cases in the present study.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.382234185733513%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eItem\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.921938088829071%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCase No.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.864064602960969%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (yr)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.266487213997308%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinical Presentation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.920592193808883%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSite\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.537012113055182%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCA125\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(U/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.651413189771198%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHormonal therapy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.01615074024226%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.440107671601615%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.382234185733513%\" rowspan=\"28\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePEM\u003c/strong\u003e\u003c/p\u003e\u0026nbsp;\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.921938088829071%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.864064602960969%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.266487213997308%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass,\u0026nbsp;Abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.920592193808883%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.537012113055182%\" valign=\"top\"\u003e\n \u003cp\u003e737.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.651413189771198%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.01615074024226%\" valign=\"top\"\u003e\n \u003cp\u003eOvarian cystectomy, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.440107671601615%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass,\u0026nbsp;Abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRectum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e501.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e447.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBSO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e389.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;SO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRectum, Sacral ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e383.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003eMifepristone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTAH,\u0026nbsp;left\u0026nbsp;SO,\u0026nbsp;Right\u0026nbsp;salpingectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e364.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBilateral\u0026nbsp;ovarian cystectomy, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eUterosacral ligament, Lesions of adenomyosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e350.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBilateral\u0026nbsp;ovarian cystectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e285.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003eMifepristone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovarian cyst removal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eRelapse\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal incision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003eDydrogesterone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e254.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBilateral\u0026nbsp;ovarian cystectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLeft\u0026nbsp;ovarian cystectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLeft\u0026nbsp;ovarian cystectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eUterosacral ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e122.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eOvarian cystectomy, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea, Pelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003ePosterior fornix of vagina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e92.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eSO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003ePosterior fornix of vagina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLeft\u0026nbsp;SO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRectum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e82.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBilateral\u0026nbsp;ovarian cystectomy, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eRelapse\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eBilateral ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e69.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eOvarian cystectomy, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003ePosterior fornix of vagina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e61.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovarian cystectomy, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eRelapse\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding, Dysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eBilateral ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e57.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eOvarian cyst removal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea,\u0026nbsp;Abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e51.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTAH,\u0026nbsp;Left\u0026nbsp;SO\u0026nbsp;\u0026amp;\u0026nbsp;Right\u0026nbsp;oophorectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;pain, Ovarian mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e48.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003eDydrogesterone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovarian cystectomy,\u0026nbsp;Right\u0026nbsp;salpingectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBSO,\u0026nbsp;Bilateral\u0026nbsp;ovarian cystectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e41.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eOvarian cyst removal, myomectomy of broad ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eUterosacral ligament,\u0026nbsp;Myometrium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e39.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eMyomectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass,\u0026nbsp;Left abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eBilateral\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBSO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eDeveloped LG-ESS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e35.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003e/\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eBSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eOvarian cystectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"9\" valign=\"top\"\u003e\u0026nbsp;\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.382234185733513%\" rowspan=\"44\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEndometriosis malignant transformation\u003c/strong\u003e\u003c/p\u003e\u0026nbsp;\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.921938088829071%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.864064602960969%\" valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.266487213997308%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.920592193808883%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.537012113055182%\" valign=\"top\"\u003e\n \u003cp\u003e562.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.651413189771198%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.01615074024226%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.440107671601615%\" valign=\"top\"\u003e\n \u003cp\u003eRelapse ovary cancer 12 months later\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhe, Pelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e240.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhe, Pelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003ePosterior fornix of vagina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e200.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e171.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea, Pelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e69.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e68.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e64.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e58.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eIntramural space of uterus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e58.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass,\u0026nbsp;Abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e57.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e54.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e47.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e42.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e38.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e34.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eRelapse ovary cancer 10 months later\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e33.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass,\u0026nbsp;Abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e32.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e31.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans\u0026nbsp;abdominal\u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e25.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;lesions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e23.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans\u0026nbsp;abdominal\u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003ePosterior fornix of vagina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e19.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e18.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e18.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRectum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans abdominal \u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003e10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eLaparoscopic radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eTrans\u0026nbsp;abdominal\u0026nbsp;radical surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.7588325652841785%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.8341013824884795%\" valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.282642089093702%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.746543778801843%\" valign=\"top\"\u003e\n \u003cp\u003eRight\u0026nbsp;ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.602150537634408%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.439324116743471%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27956989247312%\" valign=\"top\"\u003e\n \u003cp\u003eMass removal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.056835637480798%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"9\" valign=\"top\"\u003e\n \u003cp\u003eNote: BSO, bilateral salpingo-oophorectomy;\u0026nbsp;NA,\u0026nbsp;not available; LN, lymph node; NED, no evidence of disease; SO, salpingo-oophorectomy; TAH, total\u0026nbsp;Abdominal\u0026nbsp;hysterectomy.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"91%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"9\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3 Clinical features of published PEM cases\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAuthor\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Year)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCase No.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (yr)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinical Presentation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSite\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCA125\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(U/ml)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of hormonal therapy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eParker (2004)[2]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass,\u0026nbsp;Abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003ePeritoneum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eAspiration of cyst contents, Partial excision, Left ovarian cystectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRetroperitoneum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection, Sigmoid colectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eColon, Uretus, Left Fallopian tube, Left broad ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eSigmoid resection, Resection of endometriomas, Myomectomies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eBowel obstruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eColon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eOophorectomy, Colonic resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eDOC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal polyp, Pelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eVagina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePolypectomies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003ePtritoneum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection, Ureterectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eVagina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal vault curettings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eColon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eSigmoid resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eFrequent urination, Pelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRight Ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eBSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eRecent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eColon, Para-vagina, Omentum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eExcision of pelvic masses, Cecal resection, Upper vaginectomy, Omentectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRight ureter, Vagina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eUnopposed estrogen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection, Ureterectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eRight adnexal mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUterus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eHematuria, Hydronephrosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUreter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eResection of distal right ureter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePostmenopausal bleeding, Vaginal mass, Abdominal pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eVagina, Cervix, Rectum, Ureter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO, Partial resection of rectum \u0026amp; ureter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePostmenopausal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRight ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;pain, Ovarian mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLeft adnexal mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePostmenopausal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary, Fallopian tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eBSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUterus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass, Colonic stricture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eColonic mesentery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePeritoneal biopsies, Partial colonic resection, Oophorectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eRight adrenal mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003ePeriadorenal tissue, Omentum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eUnopposed estrogen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003ePeritoneum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePartial excision of mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eBowel obstruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eColon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eColonic resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eMiyoshi (2022)[13]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eAnterior wall of the uterus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePartial excision of mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRight Ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e340\u0026thinsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eRelapse\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea, Lower\u0026nbsp;abdominal\u0026nbsp;tumor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRight adnexa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eRight SO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eJacquot (2021)[14]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic pain, Longstanding dyspareunia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eDouglas pouch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal radical colpohysterectomy with SO and ovarian transposition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eLing (2020)[15]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e58.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eRelapse\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eGhafoor (2020)[16]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003ecul-de-sac posterior to the cervical remnant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eCarbone (2020)[12]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eRecurrent pelvis mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e476\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTotal pelvic exenteration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eTsai (2019)[17]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLower\u0026nbsp;abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eDouglas pouch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e1317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eTabakin (2018)[18]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLeft back pain, Hematuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eLeft kidney\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eLeft radical nephrectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eRamai (2018)[19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eConstipation, Lower gastrointestinal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eSigmoid colon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eSigmoid colectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eLaopakorn (2018)[20]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eUrinary urgency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUrinary bladder, Left ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eSO, Resection of left sacrouterine ligament \u0026amp; bladder tumor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eZhuang (2017)[21]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eHematouria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUreter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eOral contraceptive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eUreterectomy, Partial cystectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eJaegle (2017)[10]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eHematuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary, Endometrium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e37.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTamoxifen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePosterior pelvic exentration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eIida (2017)[22]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eSwelling in the lower\u0026nbsp;abdomen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO, Omentectomy, Left pelvic lymphadenectomy, Right pelvic lymph node biopsy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eHan (2017)[23]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eDiarrhea,\u0026nbsp;Postmenopausal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRectum-sigmoid colon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eRemoval of the rectosigmoid mass, Proctosigmoidectomy, ileostomy, TAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eYamamoto (2016)[24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e3263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eVarious hormonal therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO, Partial omentectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eTham (2016)[25]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eCervix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eHysteroscopy with dilation and curettage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eTakeuchi (2016)[26]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eIrregular menstruation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUterus-Douglas pouch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO, Mass resection, Intrapelvic lymph node dissection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eKim (2015)\u0026nbsp;[27]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e595.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eGunawardane (2015)[28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLower\u0026nbsp;abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eDouglas pouch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eHRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eBiopsy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eGezer (2015)[29]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003ePouch of Douglas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e86.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eChoi (2015)[30]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTamoxifen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eYamada (2014)[31]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e121.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eJaiman (2014)[32]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal mass with discharge, Menorrhagia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eCervix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePolypectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eKoyama (2013)[33]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding, Lower\u0026nbsp;abdominal\u0026nbsp;Pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOvary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTumor resection, Uterine repair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eKozawa (2012)[34]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLower\u0026nbsp;abdominal\u0026nbsp;pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRight ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e323\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eRight SO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eMedeiros (2012)[35]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;pain, Rectal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eJejunum, Peritoneum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eUretheral obstruction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUreter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eRecurrence after 8 years\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eHansen (2012)[36]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;fullness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eRight ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePostmenopausal bleeding,\u0026nbsp;Abdominal\u0026nbsp;fullness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eEndometrium, Right ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eStaging laparotomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eDadhwal (2012)[37]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLower\u0026nbsp;abdominal\u0026nbsp;pain, Menorrhagia, Vaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eVagina, Uterus, Parametrium, Peritoneum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eBSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eLambrechts (2011)[38]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eHematuria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUrachus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eSyecle (2011)[39]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea, Dyspareunia, Pelvic pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eVagina, Cervix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eDepo-provera\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePolypectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eKwek (2010)[40]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eLeft parametrium, Sigmoid colon, Ureter, Bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eExploratory laparotomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eFelix (2010)[41]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePostcoital bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eCervix\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eUnopposed estrogen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eKondo (2009)[42]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLower back pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUreter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePartial resection of the ureter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eTakeuchi (2008)[11]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLower abdominal Pain, Vaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eDouglas pouch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003enone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, Left SO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eMarugami (2008)[43]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eLower abdominal pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUreter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eGnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTransurethral resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eKraft (2006)[44]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003ePelvic pain, Dysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eLeft ovary, Douglas pouch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e817\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTamoxifen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eLaird (2004)[45]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eAbdominal\u0026nbsp;mass, Vaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eUterus, Left ovary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e323\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO, Mass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eChang (2003)[46]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eEndometrium, Douglas pouch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e138.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTamoxifen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eTAH, BSO, Sigmoid resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNED\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eSchlesinger (1999)[47]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eVaginal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eEndometrium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTamoxifen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eBiopsy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eEndometrial cancer 8 months later\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eOthman (1996)[9]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eDysmenorrhea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eDouglas pouch, Ovary, Omentum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003ePolypectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eGrouls (1995)[48]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.125%\" valign=\"top\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eGastro-intestinal bleeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\" valign=\"top\"\u003e\n \u003cp\u003eOmentum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\" valign=\"top\"\u003e\n \u003cp\u003eMass resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"9\" valign=\"top\"\u003e\n \u003cp\u003eNote: BSO, bilateral salpingo-oophorectomy; DOC, dead from other causes; GnRH, gonadotropin releasing hormone; HRT, hormone replacement therapy;\u0026nbsp;NA,\u0026nbsp;not available; LN, lymph node; NED, no evidence of disease; SO, salpingo-oophorectomy; TAH, total\u0026nbsp;Abdominal\u0026nbsp;hysterectomy.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Polypoid endometriosis, Clinicopathological features, Cancer antigen 125","lastPublishedDoi":"10.21203/rs.3.rs-3106485/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3106485/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003ePolypoid endometriosis (PEM) is rare benign tumors with morphological features resembling malignant tumors. We aimed to analyze the clinicopathological features and outcomes of patients with PEM, and compare them to cases of endometriosis with malignant transformation.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn total 28 PEM and 44 cases of endometriosis with malignant transformation were retrospectively analyzed. Data from each of the patients was collected including clinicopathological features, treatment, and outcomes for evaluation.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eIn the PEM group patients were aged 30 to 63 years (mean, 40.7 years). The most common clinical symptoms were pelvic mass, irregular vaginal bleeding, and lower abdominal pain. The primary sites were ovary, posterior vaginal fornix, rectum, uterosacral ligament, and abdominal incision. The PEM tumors had a median maximum diameter of 5.3 cm (IQR, 3.1\u0026ndash;7.9). The follow-up data in the PEM group showed that 23/27 patients survived without residual disease, 3/27 patients survived with residual endometriosis, 1/27 patient survived with endometriosis-malignant low-grade endometrial stromal sarcoma (ESS). Compared with patients in the endometriosis with malignant transformation group, there were statistically significant differences in age, menopause, dysmenorrhea, adenomyosis, cancer antigen 125 (CA125) levels, and tumor size.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003ePEM is a benign lesion and has a risk of malignant transformation. Patients with PEM were younger with a smaller tumor size and a higher CA125 level when compared to patients with endometriosis with malignant transformation, which provides important information for the correct diagnosis of PEM.\u003c/p\u003e","manuscriptTitle":"Polypoid endometriosis mimicking malignancy: a clinicopathological analysis of 28 cases and literature review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-09-02 00:20:49","doi":"10.21203/rs.3.rs-3106485/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5281ca63-7ca6-43cc-9759-b8a681ac2cb0","owner":[],"postedDate":"September 2nd, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-10-31T20:44:32+00:00","versionOfRecord":[],"versionCreatedAt":"2023-09-02 00:20:49","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3106485","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3106485","identity":"rs-3106485","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}