Recurrence Patterns after Surgery in Patients with Different Endometriosis Subtypes: A Long-Term Hospital-Based Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Surgical Technique
2.2. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Time to Recurrence
3.3. Recurrent Endometriosis Subtype, Based on Subtype at First Surgery
3.4. Evolution of Endometriosis Subtypes over Recurrent Surgeries
4. Discussion
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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First Surgery | SUP | OMA | DIE | Unknown | p | |
---|---|---|---|---|---|---|
Characteristics | (n = 56) | (n = 124) | (n = 54) | (n = 88) | ||
Age (y ± SD) | 27.7 ± 6.4 | 29.4 ± 5.3 | 30.1 ± 5.0 | 29.4 ± 6.6 | ns | |
Median time to second surgery (min-max, months) | 30.5 (5–216) | 30 (6–244) | 36 (4–141) | 33.5 (5–190) | ns | |
First surgery in external hospital | 43 (76.8%) | 109 (87.9%) | 33 (61.1%) | 85 (96.6%) | <0.001 * | |
Second surgery in external hospital | 12 (21.4%) | 40 (32.3%) | 12 (22.2%) | 33 (37.5%) | ns | |
One recurrence | 100% | 100% | 100% | 100% | n/a | |
Two recurrences | 18 (32.1%) | 52 (41.9%) | 18 (33.3%) | 44 (50.0%) | ns | |
Three recurrences | 4 (7.1%) | 16 (12.9%) | 8 (14.8%) | 22 (25.0%) | ns | |
Four recurrences | 2 (3.6%) | 4 (3.2%) | 4 (7.4%) | 13 (14.8%) | ns | |
Five recurrences | 0 | 0 | 1 (1.9%) | 3 (3.4%) | ns |
First Surgery | SUP (N = 56) Median Time to Recurrence (Min–Max) | p OR (95% CI) 1 | OMA (N = 124) Median Time to Recurrence (Min–Max) | p OR (95% CI) 2 | DIE (N = 54) Median Time to Recurrence (Min–Max) | p OR (95% CI) 3 | |
---|---|---|---|---|---|---|---|
Recurrent Surgery | |||||||
SUP | 17 (30.4%) | 0.001 | 10 (8.1%) | 0.0011 | 9 (16.7%) | ns | |
30 (9–194) | 3.65 | 28 (7–244) | 0.28 | 31 (5–116) | |||
(1.74, 7.51) | (0.14, 0.62) | ||||||
OMA | 10 (17.9%) 71.5 (6–216) | 0.0036 0.34 (0.17, 0.73) | 58 (46.8%) 27 (6–222) | <0.0001 3.72 (2.04, 6.74) | 11 (20.4%) 36 (6–141) | 0.021 0.42 (0.2, 0.87) | |
DIE | 27 (48.2%) | ns | 49 (39.5%) | ns | 29 (53.7%) | ns | |
27 (5–139) | 51 (8–135) | 39 (18–119) | |||||
Unknown subtype | 2 (3.6%) | ns | 5 (4.0%) | ns | 5 (9.3%) | ns | |
31.5 (12.51) | 30 (12–156) | 24 (4–31) |
(a) | |||||||||
Location of OMA at 1st Surgery | Bilateral n = 13 (22.4%) | Unilateral Left n = 21 (36.2%) | Unilateral Right n = 14 (24.1%) | Unknown n = 10 (17.2%) | |||||
Location of OMA at 2nd Surgery | |||||||||
Bilateral | 6 (46.2%) | 9 (42.9%) | 4 (28.6%) | 4 (40.0%) | |||||
Unilateral left | 3 (23.1%) | 8 (38.1%) | 3 (21.4%) | 1 (10.0%) | |||||
Unilateral right | 4 (30.8%) | 4 (19.0%) | 7 (50.0%) | 3 (30.0%) | |||||
Unknown | 0 (0%) | 0 (0%) | 0 (0%) | 2 (20.0%) | |||||
(b) | |||||||||
First Surgery | DIE | SUP n = 27 | OMA n = 49 | ||||||
Uterosacral Ligament n = 3/29 | Vagina n = 11/29 | Intestine n = 10/29 | Bladder n = 1/29 | Others * n = 4/29 | |||||
DIE Location at Second Surgery | |||||||||
Uterosacral ligament | 0 | 1 (3.4%) | 1 (3.4%) | 1 (3.4%) | 1 (3.4%) | 7 (25.9%) | 9 (18.4%) | ||
Vagina | 0 | 8 (27.6%) | 5 (17.2%) | 0 | 0 | 10 (37.0%) | 23 (46.9%) | ||
Intestine | 1 (3.4%) | 4 (13.8%) | 4 (13.8%) | 0 | 2 (6.9%) | 12 (44.4%) | 15 (30.6%) | ||
Bladder | 0 | 0 | 0 | 0 | 0 | 2 (7.4%) | 3 (6.1%) | ||
Others * | 2 (6.9%) | 1 (3.4%) | 1 (3.4%) | 0 | 1 (3.4%) | 1 (3.7%) | 5 (10.2%) |
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Nirgianakis, K.; Ma, L.; McKinnon, B.; Mueller, M.D. Recurrence Patterns after Surgery in Patients with Different Endometriosis Subtypes: A Long-Term Hospital-Based Cohort Study. J. Clin. Med. 2020, 9, 496. https://doi.org/10.3390/jcm9020496
Nirgianakis K, Ma L, McKinnon B, Mueller MD. Recurrence Patterns after Surgery in Patients with Different Endometriosis Subtypes: A Long-Term Hospital-Based Cohort Study. Journal of Clinical Medicine. 2020; 9(2):496. https://doi.org/10.3390/jcm9020496
Chicago/Turabian StyleNirgianakis, Konstantinos, Lijuan Ma, Brett McKinnon, and Michael D. Mueller. 2020. "Recurrence Patterns after Surgery in Patients with Different Endometriosis Subtypes: A Long-Term Hospital-Based Cohort Study" Journal of Clinical Medicine 9, no. 2: 496. https://doi.org/10.3390/jcm9020496