Risk Factors for Postoperative Recurrence of Ovarian Endometrioma in Young Women

Xing Xin, Xiaochen Song, Xinyang Zhao, Shanshan Wu, Xinyao Hao, Aixin Song, Zifan Meng, Jiarui Qi, Jichun Tan
In: Research Square · 2021 · doi:10.21203/rs.3.rs-449055/v1 · W3161640799
preprint OA: green CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

In young women, revised American Fertility Society disease stage and postoperative dysmenorrhea increase ovarian endometrioma recurrence risk, while postoperative pregnancy is protective.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study evaluated 196 young women (≤21 years) who underwent ovarian endometrioma resection at Peking Union Medical College Hospital and Shengjing Hospital, with at least 3 years of follow-up, to identify risk factors for postoperative recurrence using preoperative histories, laboratory measures (including CA-125), intraoperative staging (rAFS), and follow-up symptom data. The cumulative recurrence rate was 8.0% at 3 years and 20.3% at 5 years, and univariate analyses found differences between recurrence and non-recurrence groups for CA-125 levels, rAFS disease stage, postoperative pregnancy, and postoperative dysmenorrhoea. Multivariate Cox modeling indicated that higher rAFS disease stage and postoperative dysmenorrhoea were risk factors for recurrence, while postoperative pregnancy was protective, with no significant associations for several other demographic and surgical variables including age, BMI, cyst size, surgical approach, and postoperative medication. The paper’s key limitation is that it is a non-randomized preprint using retrospective data. This paper is centrally about endometriosis—specifically risk factors for recurrence after surgery for ovarian endometrioma in young women.

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Abstract

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

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endometriomadysmenorrhea

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