Impact of GnRH agonist treatment on recurrence of ovarian endometriomas after conservative laparoscopic surgery
Received 11 August 2007; received in revised form 12 November 2007; accepted 12 November 2007. published online 31 March 2008.
Objective
To analyze the influence of postoperative GnRH agonist treatment on disease recurrence after conservative laparoscopic surgery for ovarian endometriomas according to duration of the treatment.
Design
Retrospective cohort study.
Setting
University hospital.
Patient(s)
One hundred nine consecutive premenopausal women who underwent conservative laparoscopic surgery for ovarian endometriomas (endometriosis stage III/IV) were enrolled in the study. The patients were divided into four treatment groups: expectant management (n = 37) and GnRH agonist therapy for 3 (n = 28), 4 (n = 21), and 6 months (n = 23).
Intervention(s)
None.
Main Outcome Measure(s)
An ultrasound confirmed recurrence of ovarian endometriomas.
Result(s)
The overall crude recurrence rate was 16.5% after follow-up for an average of 20.1 months. The crude recurrence and the cumulative probabilities of disease recurrence at 24/36 months tended to be lower in patients who received a GnRH agonist for 6 months (4.3%, 5.3%/5.3%) compared with those who received it for 3 months (17.9%, 12.5%/25.0%) and 4 months (28.6%, 18.9%/39.2%) and patients with expectant management (16.2%, 22.4%/37.9%). However, the differences did not reach statistical significance.
Conclusion(s)
Treatment with GnRH agonist for six months had a beneficial impact on the recurrence rate after conservative laparoscopic surgery for ovarian endometriomas.
cDepartment of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
Reprint requests: Seok Hyun Kim, M.D., Department of OB/GYN, College of Medicine, Seoul National University, 28 Yeongeon, Chongno, Seoul 110–744, South Korea (FAX: 82-2-762-3599).
The first two author contributed equally to this paper.
ABSTRACT