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Predicting disease recurrence in patients with endometriosis: an observational study
Sarah J Holdsworth-Carson1,2, Jessica Chung3,4, Dorothy A Machalek5,6
1Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia. Sarah.Carson@epworth.org.au.
BMC Medicine
|August 7, 2024
Summary
Endometriosis recurrence risk factors like bowel lesions, adhesions, and adenomyosis should guide treatment after initial diagnosis. Understanding these predictors aids in managing the disease effectively post-surgery.
Area of Science:
- Gynecology
- Surgical Oncology
Background:
- Endometriosis recurrence is common despite interventions.
- Limited data exists on predicting recurrence risk after initial diagnosis.
Purpose of the Study:
- To identify clinical and survey data predictors of endometriosis recurrence risk.
Main Methods:
- Observational study of 794 patients undergoing surgery for endometriosis or pelvic pain.
- Statistical analyses included logistic regression (Lasso), RiskSLIM, and survival analyses.
- Patients stratified by self-reported or surgically confirmed recurrence.
Main Results:
- Key recurrence predictors identified: adhesions, deep disease, bowel lesions, adenomyosis, high rASRM score, pelvic pain ER visits, early menarche, high gravidity, hypertension, older age.
- RiskSLIM model predicted recurrence risk at 95.3% using adenomyosis and adhesions.
- Survival analysis emphasized bowel lesions, adhesions, and adenomyosis.
Conclusions:
- Bowel lesions, adhesions, and adenomyosis are significant predictors of endometriosis recurrence.
- These factors should inform clinical decision-making for disease management post-diagnosis.
