title: Clinicopathologic risk factors for recurrence of ovarian endometrioma following laparoscopic cystectomy.
abstract: OBJECTIVE
  To identify epidemiologic risk factors and investigate whether the characteristics of removed ovarian tissue during surgery influence the recurrence of endometriomas.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Medical university hospital.
  
  
  METHODS
  248 women with endometriomas.
  
  
  METHODS
  All women who had a minimum of 2 years of follow-up after the laparoscopic excision of endometriomas were analysed retrospectively. Specimens were analysed histologically.
  
  
  METHODS
  Sixteen epidemiologic variables were analysed as possible risk factors for recurrence. The association between the characteristics of removed ovarian tissue (the thickness of the cyst wall, the thickness of ovarian tissue, and the morphological features) and endometrioma recurrence was investigated.
  
  
  RESULTS
  The cumulative incidence of endometriomas reached 42% at 60 months after surgery. We identified only a younger age at surgery as a risk factor, and postoperative pregnancy as a preventive factor. There were no differences in the mean thickness of the cyst wall and the removed ovarian tissue between patients with and without recurrence. No statistically significant associations were found between the morphologic characteristics of removed cyst wall, ovarian tissue, graded on a semi-quantitative basis, and recurrence.
  
  
  CONCLUSIONS
  These results suggest that the rate of endometrioma recurrence had a significant relation to patient age and postoperative pregnancy; however, there was no association between the histological characteristics of the excised tissue and recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan. ksen@asahikawa-med.ac.jp
authors.forename: Kazuo
authors.initials: K
authors.lastname: Sengoku
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Michiharu
authors.initials: M
authors.lastname: Horikawa
authors.forename: Hideto
authors.initials: H
authors.lastname: Katayama
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Nishiwaki
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Kato
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kawanishi
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Saijo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D004715:Endometriosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D015999:Multivariate Analysis; D010049:Ovarian Diseases / Q000473:pathology* / Q000601:surgery; D011247:Pregnancy; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055815:Young Adult