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<p>This study aimed to identify risk and protective factors for postoperative recurrence of deep infiltrating endometriosis (DIE). We analyzed 320 patients undergoing laparoscopic excision with ≥ 6 years follow-up at the First Affiliated Hospital of Sun Yat-sen University. Cumulative recurrence rates increased from 7.1% at 6 years to 14.1% by 12 years post-surgery. Multivariate analysis identified left ovarian endometrioma (EMA) as an independent risk factor (HR: 6.413, 95% CI: 2.961–13.889, <i>P</i> &lt; 0.001), while older age (HR: 0.836, 95% CI: 0.788–0.887, <i>P</i> &lt; 0.001), GnRH-a use ≥ 6 months (HR: 0.324, 95% CI: 0.178–0.589, <i>p</i> &lt; 0.001), and postoperative pregnancy (HR: 0.847, 95% CI: 0.179–0.748, <i>p</i> = 0.006) were protective. Gravidity, parity, and unilateral EMA showed univariate associations (<i>P</i> &lt; 0.05), but BMI, dysmenorrhea severity, infertility, and hysterectomy status were nonsignificant. These findings highlight left-side EMA presence was an independent risk factor for the recurrence of deep infiltrating endometriosis after surgery during long-term follow-up. Age, use of GnRH-a for 6 months and postoperative pregnancy were protective factors against recurrence.</p>

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Risk factors for postoperative recurrence of deep infiltrating endometriosis during a 6- to 12-year follow-up

  • 期刊论文

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  • 发表日期：

    2025年10月28日

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  • Hungling Kwok,
  • Jinbo Li,
  • Xiao Li,
  • Hongye Jiang,
  • Tian Li,
  • Shuqin Chen

摘要

This study aimed to identify risk and protective factors for postoperative recurrence of deep infiltrating endometriosis (DIE). We analyzed 320 patients undergoing laparoscopic excision with ≥ 6 years follow-up at the First Affiliated Hospital of Sun Yat-sen University. Cumulative recurrence rates increased from 7.1% at 6 years to 14.1% by 12 years post-surgery. Multivariate analysis identified left ovarian endometrioma (EMA) as an independent risk factor (HR: 6.413, 95% CI: 2.961–13.889, P < 0.001), while older age (HR: 0.836, 95% CI: 0.788–0.887, P < 0.001), GnRH-a use ≥ 6 months (HR: 0.324, 95% CI: 0.178–0.589, p < 0.001), and postoperative pregnancy (HR: 0.847, 95% CI: 0.179–0.748, p = 0.006) were protective. Gravidity, parity, and unilateral EMA showed univariate associations (P < 0.05), but BMI, dysmenorrhea severity, infertility, and hysterectomy status were nonsignificant. These findings highlight left-side EMA presence was an independent risk factor for the recurrence of deep infiltrating endometriosis after surgery during long-term follow-up. Age, use of GnRH-a for 6 months and postoperative pregnancy were protective factors against recurrence.