Reproductive performance, pain recurrence and disease relapse after conservative surgical treatment for endometriosis : the predictive value of the current classification system
Articolo
Data di Pubblicazione:
2006
Citazione:
Reproductive performance, pain recurrence and disease relapse after conservative surgical treatment for endometriosis : the predictive value of the current classification system / P. Vercellini, L. Fedele, G. Aimi, O. De Giorgi, D. Consonni, P.G. Crosignani. - In: HUMAN REPRODUCTION. - ISSN 0268-1161. - 21:10(2006), pp. 2679-2685.
Abstract:
BACKGROUND: To assess the predictive value of the current classification of endometriosis in terms of response to
surgical treatment, we studied to what extent disease stage, lesion type and lesion site were associated with postoperative
pregnancy rate, symptom recurrence and disease relapse. METHODS: A total of 729 women with endometriosis
undergoing first-line conservative laparoscopic surgery were included. Data on age at surgery, disease stage
according to the revised American Fertility Society (AFS) classification, anatomical characteristics of endometriotic
lesions, fertility status and types and severity of pain symptoms were collected. RESULTS: Minimal endometriosis
was present in 222 patients, mild in 106, moderate in 197 and severe in 204. The cumulative probability of pregnancy
at 3 years from surgery in 537 infertile women was 47% (51% at stage I, 45% at stage II, 46% at stage III and 44% at
stage IV; log-rank test, c2
3 = 1.50, P = 0.68). The cumulative probability of moderate or severe dysmenorrhoea recurrence
in 425 symptomatic subjects was 24% (32% at stage I, 24% at stage II, 21% at stage III and 19% at stage IV;
log-rank test, c2
3 = 6.39, P = 0.094). The cumulative probability of disease relapse was 12% (3% at stage I, 11% at
stage II, 11% at stage III and 23% at stage IV; log-rank test, c2
3 = 24.95, P = 0.0001). Using Cox’s multivariate proportional
hazards regression analysis, no association was observed between endometriosis stage or lesion type and
lesion site and any of the considered study outcomes. CONCLUSIONS: The current classification of endometriosis
has an inadequate predictive value with regard to the major clinical outcomes.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
classification ; endometriosis ; infertility ; pelvic pain ; recurrence
Elenco autori:
P. Vercellini, L. Fedele, G. Aimi, O. De Giorgi, D. Consonni, P.G. Crosignani
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