title: Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis.
abstract: To investigate whether postoperative GnRH agonist (GnRH-a) treatment can prevent endometriosis recurrence.
  
  
  
  This meta-analysis searched PubMed, Embase and Cochrane Library for relevant studies published online before June 2015. Seven randomized controlled trials including 328 patients with postoperative GnRH-a treatment and 394 patients in control group were included in the meta-analysis. In the meta-analysis, the recurrence rate of GnRH-a group compared with control group was evaluated with odds ratio (OR) and its 95 % confidence interval (CI). Heterogeneity, small study effect and publication bias were, respectively, assessed using Higgins I (2), sensitivity analysis and funnel plot.
  
  
  
  Postoperative GnRH-a treatment for endometriosis (pooled OR = 0.71; 95 % CI 0.52-0.96) was superior to expectant or placebo treatment in prevention of the recurrence. The recurrence rate decreased significantly in patients who received 6 months GnRH-a treatment (pooled OR = 0.59, 95 % CI 0.38-0.90), whereas no significant difference of recurrence rate existed between patients with 3 months post-surgical GnRH-a therapy and the control group (pooled OR = 0.87, 95 % CI 0.56-1.34). No significant heterogeneity and small study effect were found in the meta-analysis. However, publication bias did existed in the present meta-analysis.
  
  
  
  Longer-term (6 months) postoperative administration of GnRH-a can decrease the recurrence risk of endometriosis, whereas 3 months duration of GnRH-a therapy makes no significant difference in preventing the recurrence of endometriosis. Therefore, instead of a 3 month therapy, the duration of the postoperative administration should be longer enough (6 months) to prevent the recurrence of endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.
authors.forename: Qiaomei
authors.initials: Q
authors.lastname: Zheng
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.
authors.forename: Hongluan
authors.initials: H
authors.lastname: Mao
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Wei
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China. peishu_liu@126.com.
authors.forename: Peishu
authors.initials: P
authors.lastname: Liu
mesh_terms: D003131:Combined Modality Therapy; D004715:Endometriosis / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures; D006801:Humans; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D055502:Secondary Prevention
chemical_list: D007987:Gonadotropin-Releasing Hormone
keywords: Endometriosis; GnRH agonist; Meta-analysis; Recurrence