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Risk factors for ovarian endometrioma recurrence following surgical excision: a systematic review and meta‑analysis

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Abstract

Purpose

Exploring potential risk factors for OMA recurrence, thereby contributing to the individual management of the disease and improving the patients’ prognosis.

Methods

Data sources PubMed, Embase, the Cochrane Library, CNKI, and Wanfang data were searched systematically before October 2020. We computed the pooled odd ratios or the standard mean difference with their corresponding 95% confidence interval to investigate the impact of involved risk factors on endometrioma recurrence.

Results

The pooled findings of this meta-analysis demonstrated that endometrioma relapse was closely related to age at surgery [SMD (95% CI):  − 0.28 (- − 0.38 to  − 0.17), P < 0.00001], CA125 level [SMD (95% CI): 0.51 (0.14–0.88), P = 0.007], cyst size [SMD (95% CI): 0.35 (0.08–0.62), P = 0.01], dysmenorrhea [OR (95% CI): 1.47 (1.07–2.02), P = 0.02], endometriosis-related surgery history [OR (95% CI): 2.60 (1.84–3.67), P < 0.00001], pre-operative medication [OR (95% CI): 2.13 (1.41–3.22), P = 0.0003], rASRM score [SMD (95% CI): 0.33 (0.20–0.46), P < 0.00001]. Furthermore, post-operative pregnancy was indicated a protective factor for preventing the OMA recurrence after surgery [OR (95% CI): 0.22 (0.09–0.56), P = 0.001]

Conclusion

Age at surgery, CA125 level, cyst size, dysmenorrhea, endometriosis-related surgery history, pre-operative medication, rASRM score were risk factors for endometrioma relapse. In addition, post-operative pregnancy was a protective factor for preventing recurrence after surgery. However, the effect of bilateral involvement, combination with adenomyosis, or post-operative medication on endometrioma relapse need further investigations.

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Authors and Affiliations

  1. Graduate School, Dalian Medical University, Dalian, 116044, Liaoning, China

    Danni Jiang, Xuxing Zhang, Jiaqi Shi & Dongmei Tao

  2. Department of Gynecology, Shenyang Women’s and Children’s Hospital, 87 Danan Street, Shenyang, 110011, Liaoning, China

    Xiaocui Nie

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  1. Danni Jiang
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DNJ: data collection and manuscript writing with editing. XXZ: data collection. JQS and DMT: data analysis. XCN: manuscript supervision and revision.

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Correspondence to Xiaocui Nie.

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Jiang, D., Zhang, X., Shi, J. et al. Risk factors for ovarian endometrioma recurrence following surgical excision: a systematic review and meta‑analysis. Arch Gynecol Obstet 304, 589–598 (2021). https://doi.org/10.1007/s00404-021-06129-0

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