| Comparison of short-term recurrence rate after different drug treatments for ovarian endometrioid cyst after conservative operation |
| Received:May 09, 2020 Revised:July 04, 2020 Click here to download the full text |
| Citation of this paper:ZHANG Chen-yun,LU Yuan.Comparison of short-term recurrence rate after different drug treatments for ovarian endometrioid cyst after conservative operation[J].Chinese Journal of Clinical Medicine,2020,27(5):742-749 |
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| Abstract:Objective: To explore the preventive effect of different drug treatments on recurrence after conservative operation of ovarian endometrioid cyst (OEC), and select the optimal drug treatment. Methods: A total of 136 patients with OEC who underwent laparoscopic conservative surgery in the Affiliated Obstetrics and Gynecology Hospital, Fudan University from July 2015 to February 2017 were divided into four groups according to postoperative drug treatments: simple operation group (n=58), gonadotropin releasing hormone agonist (GnRHa) treatment group (3 cycles of GnRHa injection, n=28), contraceptives (OC) treatment group (oral contraceptive 12 months after operation, n=20), and sequential treatment group (GnRHa injection was given for 3 cycles after operation, and contraceptive was taken orally after menstruation recovered to 12 months after operation, n=30). The cumulative recurrence rate, adverse reactions of patients in each group were compared at 1, 3, 6, 12, 18, and 24 months after operation, and the influencing factors of postoperative recurrence were analyzed. Results: After the 24-month follow-up, 23 of the 136 patients had recurrence, with a recurrence rate of 16.9%. The cumulative recurrence rates of patients in simple operation group, GnRHa treatment group, contraceptive treatment group, and sequential treatment group were 28.3%, 28.1%, 15.0%, and 3.3%, respectively, and the median recurrence-free interval was 27.37, 25.89, 29.47, and 30.16 months, respectively. The cumulative recurrence rate 24 months after operation in the sequential treatment group was significantly lower than that in the simple operation group and GnRHa treatment group (P<0.05). The incidences of peri-menopausal symptoms, irregular vaginal bleeding in sequential treatment group were significantly higher than those in simple operation group. The independent risk factors of postoperative recurrence included the history of previous EMs surgery (HR=3.480, P=0.015) and the multilocular or septate cyst (HR=2.307, P=0.049). Conclusions: There is a certain recurrence rate after conservative operation of OEC, and previous EMs operation history, multilocular or septate cyst are independent risk factors for recurrence, postoperative GnRHa combined with OC sequential therapy can effectively reduce the recurrence of OEC, but it will be complicated with peri-menopausal symptoms and other adverse reactions, which should be paid more attention to. |
| keywords:ovarian endometrioid cyst conservative surgery oral contraceptive gonadotropin releasing hormone agonists recurrence |
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