Predictors of leiomyoma recurrence after myomectomy.
OBJECTIVE
The purpose of this study was to evaluate the factors associated with the recurrence of leiomyomata after myomectomy.


METHODS
One hundred forty-five consecutive cases of myomectomy by laparotomy were studied retrospectively. Leiomyoma recurrence, diagnosed by transvaginal ultrasonography, was evaluated by life-table analysis and log-rank tests according to clinical characteristics of patients.


RESULTS
The 5-year cumulative rates for leiomyoma recurrence and subsequent major surgery were 62% and 9%, respectively. At 5 years, the cumulative probability of recurrence was significantly lower in patients with a single leiomyoma removed (11%), compared with patients with multiple leiomyomata (74%) (P = .011); it was also lower in patients with intraoperative uterine size 10 menstrual weeks or less (46%), compared with more than 10 menstrual weeks (82%) (P = .032). However, there was a strong association of uterine size with the number of leiomyomata removed (P = .009). Childbirth after myomectomy was associated with a lower recurrence rate; the 5-year cumulative probability of recurrence was 26% in patients with subsequent parity, compared with 76% in those without subsequent parity (P = .010).


CONCLUSIONS
Solitary myomectomy and smaller intraoperative uterine size are associated with lower rates of leiomyoma recurrence after myomectomy; the significance of uterine size may be affected by its correlation with the number of leiomyomata removed. Subsequent parity is associated with a lower probability of recurrence, but the cause and effect relationship between these two variables is unclear.


METHODS
II-3.
Hanafi
Magdi
M
Saint Joseph's Hospital of Atlanta, Georgia 30342, USA. Mhanafi@aol.com
D000328:Adult; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*