Risk factors of ovarian endometrioma recurrence after laparoscopic cystectomy

Kayo Takahashi, Atsuko Suzuki, Aya Sasase, Akiko Otake, Naoko Sasamoto, Yukari Miyoshi, Mitsunori Shioji, Yoshimitsu Yamamoto, Kyoka Amemiya, Kazushige Adachi
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2015 · vol. 31(1) , pp. 126–131 · doi:10.5180/jsgoe.31.126 · W2717971852
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Retrospective study of 81 women followed after laparoscopic cystectomy for ovarian endometrioma found a 12.3% recurrence rate associated with larger cyst size, multiple cysts, and prior medical treatment, while postoperative medical therapy reduced recurrence (3.3% vs 20.6%).

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This retrospective study evaluated risk factors for ovarian endometrioma recurrence in 81 women who underwent laparoscopic cystectomy and were followed for more than 4 months, with 18 clinical, surgical, and treatment-related variables analyzed (including cyst size, single versus multiple cysts, prior endometriosis treatment, and postoperative medical treatment). Recurrence occurred in 12.3% (10/81) of participants, with a 5-year cumulative recurrence rate of 37%. Larger maximal cyst size, presence of multiple cysts, and previous medical treatment were associated with higher recurrence, while postoperative medical treatment was linked to a lower recurrence rate (3.3% with treatment vs 20.6% without). The study is limited by its retrospective design and lack of control over treatment allocation. This paper is centrally about endometriosis — specifically, risk factors and postoperative medical treatment effects on ovarian endometrioma recurrence after laparoscopic cystectomy.

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Abstract

Objective: To evaluate risk factors associated with ovarian endometrioma recurrence after laparoscopic cystectomy.Design: A retrospective study.Setting: Minoh City Hospital.Patients: This study included 81 women who underwent laparoscopic cystectomy for ovarian endometrioma and were followed up postoperatively for more than 4 months. Interventions: Laparoscopic cystectomy and postoperative medical treatment.Main outcomes: Eighteen variables (age at surgery, body mass index, age at menarche, parity, infertility, pain, previous surgery for ovarian endometriosis, previous medical treatment of endometriosis, tumor marker, size of the largest cyst, single or multiple cysts, unilateral or bilateral involvement, laterality [left or right], revised American Society for Reproductive Medicine [r-ASRM] score, r-ASRM stage, uterine myoma, postoperative medical treatment, and postoperative pregnancy) were evaluated to assess their effects on the risk of ovarian endometrioma recurrence.Results: The recurrence rate was 12.3% (10/81 patients). The 5-year cumulative recurrence rate was 37%. The size of the largest cyst, presence of multiple cysts, and previous medical treatment were associated with ovarian endometrioma recurrence. The recurrence rate was significantly lower in the women who received postoperative medical treatment (3.3%) than in the women who did not receive medication (20.6%).Conclusion: In this study, the size of the largest cyst and the presence of multiple cysts were associated with ovarian endometrioma recurrence after laparoscopic cystectomy. The continuous postoperative medical treatment decreased the risk of ovarian endometrioma recurrence.
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Objective

To evaluate risk factors associated with ovarian endometrioma recurrence after laparoscopic cystectomy. Design: A retrospective study. Setting: Minoh City Hospital. Patients: This study included 81 women who underwent laparoscopic cystectomy for ovarian endometrioma and were followed up postoperatively for more than 4 months. Interventions: Laparoscopic cystectomy and postoperative medical treatment. Main outcomes: Eighteen variables (age at surgery, body mass index, age at menarche, parity, infertility, pain, previous surgery for ovarian endometriosis, previous medical treatment of endometriosis, tumor marker, size of the largest cyst, single or multiple cysts, unilateral or bilateral involvement, laterality [left or right], revised American Society for Reproductive Medicine [r-ASRM] score, r-ASRM stage, uterine myoma, postoperative medical treatment, and postoperative pregnancy) were evaluated to assess their effects on the risk of ovarian endometrioma recurrence.

Results

The recurrence rate was 12.3% (10/81 patients). The 5-year cumulative recurrence rate was 37%. The size of the largest cyst, presence of multiple cysts, and previous medical treatment were associated with ovarian endometrioma recurrence. The recurrence rate was significantly lower in the women who received postoperative medical treatment (3.3%) than in the women who did not receive medication (20.6%).

Conclusion

In this study, the size of the largest cyst and the presence of multiple cysts were associated with ovarian endometrioma recurrence after laparoscopic cystectomy. The continuous postoperative medical treatment decreased the risk of ovarian endometrioma recurrence. Design: A retrospective study. Setting: Minoh City Hospital. Patients: This study included 81 women who underwent laparoscopic cystectomy for ovarian endometrioma and were followed up postoperatively for more than 4 months. Interventions: Laparoscopic cystectomy and postoperative medical treatment. Main outcomes: Eighteen variables (age at surgery, body mass index, age at menarche, parity, infertility, pain, previous surgery for ovarian endometriosis, previous medical treatment of endometriosis, tumor marker, size of the largest cyst, single or multiple cysts, unilateral or bilateral involvement, laterality [left or right], revised American Society for Reproductive Medicine [r-ASRM] score, r-ASRM stage, uterine myoma, postoperative medical treatment, and postoperative pregnancy) were evaluated to assess their effects on the risk of ovarian endometrioma recurrence.

Results

The recurrence rate was 12.3% (10/81 patients). The 5-year cumulative recurrence rate was 37%. The size of the largest cyst, presence of multiple cysts, and previous medical treatment were associated with ovarian endometrioma recurrence. The recurrence rate was significantly lower in the women who received postoperative medical treatment (3.3%) than in the women who did not receive medication (20.6%).

Conclusion

In this study, the size of the largest cyst and the presence of multiple cysts were associated with ovarian endometrioma recurrence after laparoscopic cystectomy. The continuous postoperative medical treatment decreased the risk of ovarian endometrioma recurrence. © 2015 日本産科婦人科内視鏡学会

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endometriosisendometriomainfertility

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