Adjuvant therapy in conservative surgery for adenomyosis.
adenomyosis
conservative surgery
gonadotropin-releasing hormone agonist
levonorgestrel-releasing intrauterine system
recurrence
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
revised:
08
11
2020
received:
23
09
2020
accepted:
22
12
2020
pubmed:
29
12
2020
medline:
29
6
2021
entrez:
28
12
2020
Statut:
ppublish
Résumé
To investigate the significance of perioperative levonorgestrel-releasing intrauterine system (LNG-IUS) and/or gonadotropin-releasing hormone agonists (GnRHa) as adjuvant therapy in preventing recurrences or progression of diseases. Medical records were collected from patients diagnosed with adenomyosis who underwent uterus-sparing surgeries from March 1, 2012 to December 31, 2018. The associations of perioperative adjuvant therapy with recurrence of disease and symptoms were analyzed with the Kaplan-Meier method and proportional hazards models with hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 322 eligible patients were included, of whom 173 (58.1%) received perioperative adjuvant therapy. Perioperative adjuvant therapy (HR 0.44, 95% CI 0.22-0.91, P = 0.022) and perioperative GnRHa therapy (HR 0.48, 95% CI 0.24-0.99, P = 0.042) significantly reduced disease recurrence. No patient using perioperative LNG-IUS therapy experienced recurrence. In the multivariate analysis, increased age (>35 years at surgery) was the only risk factor for disease recurrence (HR 2.35, 95% CI 1.01-5.45, P = 0.047). Perioperative adjuvant therapy with GnRHa and/or the LNG-IUS can significantly reduce disease recurrence or progression for adenomyosis patients undergoing uterus-sparing surgery. Older patients are more likely to experience disease recurrence.
Substances chimiques
Delayed-Action Preparations
0
Levonorgestrel
5W7SIA7YZW
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
119-126Subventions
Organisme : CAMS Innovation Fund for Medical Sciences
ID : CIFMS-2017-I2M-1-002
Informations de copyright
© 2020 International Federation of Gynecology and Obstetrics.
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