Assessment of risk factors for progression and recurrence of ovarian endometriosis

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OBJECTIVE

To determine the most significant clinical and anamnestic risk factors for the progression and postoperative recurrence of ovarian endometriosis, evaluate the effectiveness treatment to prevent post-surgical disease recurrence.

MATERIAL AND METHODS

126 case histories of patients with diagnosed ovarian endometriosis were studied, which met the inclusion criteria. An analysis was made of clinical and anamnestic data, the results of the histological method of investigation after surgical treatment, as well as a specially designed questionnaire in order to obtain long-term results of treatment and identify risk factors for relapse in patients with ovarian endometriosis. The appointment of Buserelin-Depo reduced the frequency of recurrence during the observation period.

RESULTS

Taking into account the evaluation of the data obtained, the most likely risk factors for recurrence of ovarian endometriosis were identified, and, among other things, the corresponding mathematical formula for determining this risk was proposed. To assess the accuracy of forecasting, an ROC-curve was constructed.

CONCLUSION

Based on the results of the study, the most significant risk factors are shown, and when using the derived mathematical formula, it is possible to predict the likelihood of recurrence of ovarian endometriosis, which makes it possible to timely identify a high risk group for the development of reccurence and predetermine the appropriate personalized management tactics, taking into account oncological alertness. It is necessary to prescribe treatment to prevent post-surgical disease recurrence with GnRH agnonists (Buserelin-Depo).

Keywords:

ovarian endometriosis

recurrence

mathematical formula

Authors:

Levakov S.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-4591-838X

Gromova T.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-6104-9842

Mamedova A.E.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-9642-4523

Received:

22.05.2023

Accepted:

30.05.2023

List of references:

Brunty S, Mitchell B, Bou-Zgheib N, Santanam N. Endometriosis and ovarian cancer risk, an epigenetic connection. Ann Transl Med. 2020;8:24:1715. https://doi.org/10.21037/atm-20-2449
Clinical recommendations. Endometriosis. Ministry of Health of the Russian Federation. 2020. (In Russ.).
Brown J, Crawford TJ, Allen C, Hopewell S, Prentice A. Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis. Cochrane Database of Systematic Reviews. 2017;1:1:CD004753. https://doi.org/10.1002/14651858.cd004753.pub4
Amro B, Ramirez Aristondo ME, Alsuwaidi S, Almaamari B, Hakim Z, Tahlak M, Wattiez A, Koninckx PR. New Understanding of Diagnosis, Treatment and Prevention of Endometriosis. Int J Environ Res Public Health. 2022;31:19:11:6725. https://doi.org/10.3390/ijerph19116725
Bulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu S, Kohlmeier A, Yin P, Milad M, Wei J. Endometriosis. Endocr Rev. 2019;40:4:1048-1079. https://doi.org/10.1210/er.2018-00242
Xu X, Chen Y, Yu Q, Wang J, Xu P, Zhu L, Xu Q, Zhang J, Cui S, Yu K, Li T, Guo X, Zhang X. The presence of living endometrial cells in ovarian endometriotic cyst fluid may contribute to the recurrence of endometriosis after surgical excision of endometriomas. J Ovarian Res. 2022;30:15:1:89. https://doi.org/10.1186/s13048-022-01018-9
Horne AW, Missmer SA. Pathophysiology, diagnosis, and management of endometriosis. 2022;14:379:e070750. https://doi.org/10.1136/bmj-2022-070750
Shafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, Missmer SA. Risk for and consequences of endometriosis: A critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1-15. https://doi.org/10.1016/j.bpobgyn.2018.06.001
Canis M, Bourdel N, Chauvet P. Years of unjustifi ed hypoestrogenism, fear, and stress will not improve the management of chronic pelvic pain! Am J Obstet Gynecol. 2019;221:2:170-171. https://doi.org/10.1016/j.ajog.2019.05.001
Falcone T, Flyckt R. Clinical management of endometriosis. Obstet Gynecol. 2018;131:3:557-571. https://doi.org/10.1097/aog.0000000000002469
Ruderman R, Pavone ME. Ovarian cancer in endometriosis: an update on the clinical and molecular aspects. Minerva ginecologica. 2017;3:69:286-294. https://doi.org/10.23736/s0026-4784.17.04042-4
Hanada T, Tsuji S, Nakayama M, Wakinoue S, Kasahara K, Kimura F, Mori T, Ogasawara K, Murakami T. Suppressive regulatory T cells and latent transforming growth factor-betaexpressing macrophages are altered in the peritoneal fuid of patients with endometriosis. Reprod Biol Endocrinol. 2018;16:1:9. https://doi.org/10.1186/s12958-018-0325-2
Symsons LK, Miller JE, Kay VR. The Immynopathophysiology of Endometriosis. Trends Molec Med. 2018;24:9:748-762. https://doi.org/10.1016/j.molmed.2018.07.004
Brilhante AV, Augusto KL, Portela MC, Sucupira LC, Oliveira LA, Pouchaim AJ, Nóbrega LR, Magalhães TF, Sobreira LR. Endometriosis and ovarian cancer: an integrative review (endometriosis and ovarian cancer). Asian Pac J Cancer Prev. 2017;1:18:1:11-16. https://doi.org/10.22034/APJCP.2017.18.1.11
Králíčková M, Laganà AS, Ghezzi F, Vetvicka V. Endometriosis and risk of ovarian cancer: what do we know? Arch Gynecol Obstet. 2020;301:1:1-10. https://doi.org/10.1007/s00404-019-05358-8
Ashrafi M, Sadatmahalleh SJ, Akhoond MR, Talebi M. Evaluation of risk factors associated with endometriosis in infertile women. Int J Ferti Steril. 2016;10:1:11-21. https://doi.org/10.22074/ijfs.2016.4763
Saha R, Kuja-Halkola R, Tornvall P, Marions L. Reproductive and lifestyle factors associated with endometriosis in a large cross-sectional population sample. J Women’s Health. 2017;26:2:152-158. https://doi.org/10.1089/jwh.2016.5795
Farland LV, Degnan WJ 3rd., Bell ML, Kasner SE, Liberman AL, Shah DK, Rexrode KM, Missmer SA. Laparoscopically confirmed endometriosis and risk of incident stroke: a prospective cohort study. Stroke. 2022;53:10:3116-3122. https://doi.org/10.1161/strokeaha.122.039250
Zakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A. Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Hum Reprod Update. 2021;4;27:1:96-107. https://doi.org/10.1093/humupd/dmaa033
Nowak-Psiorz I, Ciećwież SM, Brodowska A, Starczewski A. Treatment of ovarian endometrial cysts in the context of recurrence and fertility. Adv Clin Exp Med. 2019;28:3:407-413. https://doi.org/10.17219/acem/90767

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