Abstract | OBJECTIVE: DESIGN: A retrospective cohort study. SETTING: Medical university hospital. POPULATION: METHODS: A chart review was performed of women of reproductive age who had undergone laparoscopic surgery for endometrioma followed by three cycles of gonadotropin-releasing hormone agonist ( leuprolide acetate) treatment. Women were categorized into two groups: a group that had postoperative LNG-IUS placement (n = 42) and a group that received postoperative, cyclic, low-dose, monophasic, OCs (n = 57). Main outcome measures. Endometrioma recurrence was analyzed according to several clinical variables and postoperative treatment modalities. RESULTS: During the follow-up period (median 17 months), recurrent endometriomas were detected in eight women (8.1%). Patients with LNG-IUS had a recurrence rate of 4.8% (2/42), whereas women receiving OC had a recurrence rate of 10.5% (6/57). Cumulative recurrence-free survival assessment revealed that mean disease-free survival times for both groups were similar, but that for LNG-IUS was slightly longer than that for OC, with statistical significance (34.4 ± 1.0 months, 95% confidence interval 32.3–36.5, vs. 33.4 ± 1.3 months, 95% confidence interval 30.8–36.0, p = 0.045). Univariate analysis revealed a hazard ratio of 0.178 (95% confidence interval 0.029–1.075) (p = 0.060) for postoperative LNG-IUS use and endometrioma recurrence. However, for the multivariate regression analysis, only postoperative serum CA 125 levels were significantly associated with endometrioma recurrence (hazard ratio 1.012, p = 0.010). CONCLUSIONS: Postoperative LNG-IUS use seemed to be comparable to the use of cyclic OC in preventing endometrioma recurrence.
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Authors | Sihyun Cho, Ji Ann Jung, Yousun Lee, Hye Yeon Kim, Seok Kyo Seo, Young Sik Choi, Ji Sung Lee, Byung Seok Lee |
Journal | Acta obstetricia et gynecologica Scandinavica
(Acta Obstet Gynecol Scand)
Vol. 93
Issue 1
Pg. 38-44
(Jan 2014)
ISSN: 1600-0412 [Electronic] United States |
PMID | 24605384
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Contraceptives, Oral, Hormonal
- Gonadotropin-Releasing Hormone
- Levonorgestrel
- Leuprolide
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Topics |
- Adult
- Contraceptives, Oral, Hormonal
(administration & dosage, therapeutic use)
- Disease-Free Survival
- Endometriosis
(drug therapy, prevention & control, surgery)
- Female
- Gonadotropin-Releasing Hormone
(agonists)
- Humans
- Intrauterine Devices, Medicated
- Leuprolide
(therapeutic use)
- Levonorgestrel
(administration & dosage, therapeutic use)
- Middle Aged
- Retrospective Studies
- Secondary Prevention
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