Recurrence of endometriosis and its control

Guo, S.-W.

doi:10.1093/humupd/dmp007

Cited by 719Endometriosis Research and TreatmentEctopic Pregnancy Diagnosis and ManagementGynecological conditions and treatments

Recurrence of endometriosis and its control

Guo, S.-W.·2009·Human Reproduction Update

DOI 10.1093/humupd/dmp007

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Abstract

BACKGROUND Although surgery is currently the treatment of choice for managing endometriosis, recurrence poses a formidable challenge. To delay or to eliminate the recurrence is presently an unmet medical need in the management of endometriosis. To this end, proposals to investigate patterns of recurrence, to develop biomarkers for recurrence and to carry out biomarker-based intervention have been made. METHODS Publications pertaining to the recurrence of endometriosis and its related yet unaddressed issues were identified through MEDLINE. The reported recurrence rates, risk factors for recurrence, the effects of post-operative medication and causes of recurrence were reviewed and synthesized. In addition, several poorly explored issues such as time hazard function and mechanisms of recurrence were reviewed. Approaches to the development of biomarkers for recurrence and future intervention are discussed. RESULTS The reported recurrence rate was high, estimated as 21.5% at 2 years and 40-50% at 5 years. Few risk factors for recurrence have been consistently identified, and the evidence on the efficacy of the post-operative use of medication was scanty. The investigation on the patterns of recurrence may provide us with new insight into the possible mechanisms of recurrence and its control. The attempt to identify biomarkers for recurrence has started only very recently. CONCLUSIONS Much research is needed to better understand the patterns of recurrence and risk factors, and to develop biomarkers. One top priority is to develop biomarkers for recurrence, which may provide much needed clues to the possible mechanisms underlying recurrence and would allow the identification of patients with high recurrence risk, and permit for targeted intervention.

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Laparoscopic surgery is associated with a 70%-80% probability of partial or complete pain relief.
“Finally, patients were also informed that laparoscopic surgery was a reasonable alternative associated with a 70%-80% probability of partial or complete pain relief in case they declined medical therapy or switching from OC to a progestin, but that the risk of pain and lesion recurrence was $10% per year without long-term postoperative medical treatment (2, 3).”
From A stepped-care approach to symptomatic endometriosis management: A participatory research initiative (2018) · cites this paper as [2]
The risk of pain and lesion recurrence after laparoscopic surgery is ≥10% per year without long-term postoperative medical treatment.
“Finally, patients were also informed that laparoscopic surgery was a reasonable alternative associated with a 70%-80% probability of partial or complete pain relief in case they declined medical therapy or switching from OC to a progestin, but that the risk of pain and lesion recurrence was $10% per year without long-term postoperative medical treatment (2, 3).”
From A stepped-care approach to symptomatic endometriosis management: A participatory research initiative (2018) · cites this paper as [2]

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Estrogen receptor gene polymorphisms are associated with recurrence of endometriosis
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Flagged first, then by citations

Sorted by citations

Endometriosis: pathogenesis and treatment
Vercellini, P., Viganò, P., Somigliana, E., & Fedele, L. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2013.255 · Cited by 1,940 · see citing works
Pathophysiology, diagnosis, and management of endometriosis
Horne, A. W., & Missmer, S. A. (2022) · BMJ · doi:10.1136/bmj-2022-070750 · Cited by 661 · see citing works
Consensus on current management of endometriosis
Johnson, N. P., Hummelshoj, L., for the World Endometriosis Society Montpellier Consortium, Abrao, M. S., Adamson, G. D., Allaire, C., Amelung, V., Andersson, E., Becker, C., Birna Árdal, K. B., et al. (2013) · Human Reproduction · doi:10.1093/humrep/det050 · Cited by 558 · see citing works
Self-citation
Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist
Taylor, H. S., Giudice, L. C., Lessey, B. A., Abrao, M. S., Kotarski, J., Archer, D. F., Diamond, M. P., Surrey, E., Johnson, N. P., Watts, N. B., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1700089 · Cited by 511 · see citing works
Pathogenesis of endometriosis: The genetic/epigenetic theory
Koninckx, P. R., Ussia, A., Adamyan, L., Wattiez, A., Gomel, V., & Martin, D. C. (2019) · Fertility and Sterility · doi:10.1016/j.fertnstert.2018.10.013 · Cited by 427 · see citing works
Peripheral biomarkers of endometriosis: a systematic review
May, K. E., Conduit-Hulbert, S. A., Villar, J., Kirtley, S., Kennedy, S. H., & Becker, C. M. (2010) · Human Reproduction Update · doi:10.1093/humupd/dmq009 · Cited by 418 · see citing works
Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24-week, randomized, multicentre, open-label trial
Strowitzki, T., Marr, J., Gerlinger, C., Faustmann, T., & Seitz, C. (2010) · Human Reproduction · doi:10.1093/humrep/dep469 · Cited by 381 · see citing works
Epigenetics of endometriosis
Guo, S.-W. (2009) · Molecular Human Reproduction · doi:10.1093/molehr/gap064 · Cited by 328 · see citing works
Self-citation
Endometriosis: an overview of Cochrane Reviews
Brown, J., & Farquhar, C. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009590.pub2 · Cited by 270 · see citing works
Reduced pelvic pain in women with endometriosis: efficacy of long-term dienogest treatment
Petraglia, F., Hornung, D., Seitz, C., Faustmann, T., Gerlinger, C., Luisi, S., Lazzeri, L., & Strowitzki, T. (2012) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-011-1941-7 · Cited by 200 · see citing works
Medical treatment of endometriosis-related pain
Vercellini, P., Buggio, L., Frattaruolo, M. P., Borghi, A., Dridi, D., & Somigliana, E. (2018) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2018.01.015 · Cited by 188 · see citing works
“Waiting for Godot”: a commonsense approach to the medical treatment of endometriosis
Vercellini, P., Crosignani, P., Somigliana, E., Vigano, P., Frattaruolo, M. P., & Fedele, L. (2011) · Human Reproduction · doi:10.1093/humrep/deq302 · Cited by 180 · see citing works
“This would explain why 9% of patients do not respond to progestin treatment (Guo, 2009). by guest on Septem ber 24, 2015 http://hum rep.oxfordjournals.org/ D ow nloaded from The expression of human progesterone receptor (PR) is controlled by two promoters that direct the synthesis of mRNA…”
Background
New developments in the medical treatment of endometriosis
Bedaiwy, M. A., Alfaraj, S., Yong, P., & Casper, R. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2016.12.025 · Cited by 176 · see citing works
Post-operative use of oral contraceptive pills for prevention of anatomical relapse or symptom-recurrence after conservative surgery for endometriosis
Seracchioli, R., Mabrouk, M., Manuzzi, L., Vicenzi, C., Frasca, C., Elmakky, A., & Venturoli, S. (2009) · Human Reproduction · doi:10.1093/humrep/dep259 · Cited by 158 · see citing works
Complete surgical removal of minimal and mild endometriosis improves outcome of subsequent IVF/ICSI treatment
Opøien, H. K., Fedorcsak, P., Åbyholm, T., & Tanbo, T. (2011) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2011.06.002 · Cited by 120 · see citing works
The Role of the Lymphatic System in Endometriosis: A Comprehensive Review of the Literature1
Jerman, L. F., & Hey-Cunningham, A. J. (2015) · Biology of Reproduction · doi:10.1095/biolreprod.114.124313 · Cited by 122 · see citing works
Safety and tolerability of dienogest in endometriosis: pooled analysis from the European clinical study program
Strowitzki, T., Faustmann, T., Gerlinger, C., Schumacher, U., Ahlers, C., & Seitz, C. (2015) · International Journal of Women's Health · doi:10.2147/ijwh.s77202 · Cited by 120 · see citing works
“Surgery is a common treatment choice, but recurrence rates are high: approximately 40%–50% after 5 years.(2,3) correspondence: Thomas strowitzki Department of gynecological endocrinology and reproductive Medicine, University of Heidelberg, Voßstraße 9, 69115 Heidelberg, germany Tel +49 62 2156 7910 Fax +49 62 2156 409…”
Endometriosis-associated infertility: surgery and IVF, a comprehensive therapeutic approach
Barri, P. N., Coroleu, B., Tur, R., Barri-Soldevila, P. N., & Rodríguez, I. (2010) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2010.04.026 · Cited by 117 · see citing works
Progesterone Receptor Status Predicts Response to Progestin Therapy in Endometriosis
Flores, V. A., Vanhie, A., Dang, T., & Taylor, H. S. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-01227 · Cited by 118 · see citing works
Dienogest or Norethindrone acetate for the treatment of ovarian endometriomas: Can we avoid surgery?
Del Forno, S., Mabrouk, M., Arena, A., Mattioli, G., Giaquinto, I., Paradisi, R., & Seracchioli, R. (2019) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2019.04.010 · Cited by 88 · see citing works
Identification of cells with colony-forming activity, self-renewal capacity, and multipotency in ovarian endometriosis
Chan, R. W. S., Ng, E. H. Y., & Yeung, W. S. B. (2011) · The American Journal of Pathology · doi:10.1016/j.ajpath.2011.02.025 · Cited by 98 · see citing works
A polymorphism in a let‐7 microRNA binding site of KRAS in women with endometriosis
Grechukhina, O., Petracco, R., Popkhadze, S., Massasa, E., Paranjape, T., Chan, E., Flores, I., Weidhaas, J. B., & Taylor, H. S. (2012) · EMBO Molecular Medicine · doi:10.1002/emmm.201100200 · Cited by 96 · see citing works
Cancer-associated mutations in endometriosis: shedding light on the pathogenesis and pathophysiology
Guo, S.-W. (2020) · Human Reproduction Update · doi:10.1093/humupd/dmz047 · Cited by 96 · see citing works
Self-citation
Long-term treatment of endometriosis with dienogest: retrospective analysis of efficacy and safety in clinical practice
Römer, T. (2018) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-018-4864-8 · Cited by 82 · see citing works
Dienogest and the Risk of Endometriosis Recurrence Following Surgery: A Systematic Review and Meta-analysis
Zakhari, A., Edwards, D., Ryu, M., Matelski, J. J., Bougie, O., & Murji, A. (2020) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2020.05.007 · Cited by 86 · see citing works
Ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain: a randomized controlled trial
Harada, T., Kosaka, S., Elliesen, J., Yasuda, M., Ito, M., & Momoeda, M. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.07.1165 · Cited by 84 · see citing works
Female Perspectives on Endometriosis: Findings from the Uterine Bleeding and Pain Women'S Research Study
Bernuit, D., Ebert, A. D., Halis, G., Strothmann, A., Gerlinger, C., Geppert, K., & Faustmann, T. (2011) · Journal of Endometriosis · doi:10.5301/je.2011.8525 · Cited by 83 · see citing works
Surgical removal of superficial peritoneal endometriosis for managing women with chronic pelvic pain: Time for a rethink?
Horne, A., Daniels, J., Hummelshoj, L., Cox, E., & Cooper, K. (2019) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.15894 · Cited by 78 · see citing works
Recurrence in deep infiltrating endometriosis: a systematic review of the literature
Ianieri, M. M., Mautone, D., & Ceccaroni, M. (2018) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2017.12.025 · Cited by 76 · see citing works
Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission
Leonardo-Pinto, J. P., Benetti-Pinto, C. L., Cursino, K., & Yela, D. A. (2017) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2017.02.015 · Cited by 72 · see citing works
Recurrent endometriosis: a battle against an unknown enemy
Ceccaroni, M., Bounous, V. E., Clarizia, R., Mautone, D., & Mabrouk, M. (2019) · The European Journal of Contraception & Reproductive Health Care · doi:10.1080/13625187.2019.1662391 · Cited by 67 · see citing works
Treatment of infertility associated with deep endometriosis: definition of therapeutic balances
Somigliana, E., & Garcia-Velasco, J. A. (2015) · Fertility and Sterility · doi:10.1016/j.fertnstert.2015.08.003 · Cited by 66 · see citing works
The success of various endometrioma treatments in infertility: a systematic review and meta-analysis of prospective studies
Alborzi, S., Zahiri Sorouri, Z., Askari, E., Poordast, T., & Chamanara, K. (2019) · Reproductive Medicine and Biology · doi:10.1002/rmb2.12286 · Cited by 65 · see citing works
When more is not better: 10 ‘don’ts’ in endometriosis management. An ETIC* position statement
Club, E. E. T. I., Alio, L., Angioni, S., Arena, S., Bartiromo, L., Bergamini, V, Berlanda, N., Bonin, C., Busacca, M., Candiani, M., et al. (2019) · Human Reproduction Open · doi:10.1093/hropen/hoz009 · Cited by 64 · see citing works
“…long-term treatment with estrogen–progestins or progestins (quality of the evidence, high; strong suggestion) A cyst recurrence rate of ∼10% per year has been reported after surgery for ovarian endometriomas (Chapron et al., 2002; Koga et al., 2006; Liu et al., 2007; Guo, 2009; Koga et al., 2015).”
Background
A stepped-care approach to symptomatic endometriosis management: A participatory research initiative
Vercellini, P., Donati, A., Ottolini, F., Frassineti, A., Fiorini, J., Nebuloni, V., Frattaruolo, M. P., Roberto, A., Mosconi, P., & Somigliana, E. (2018) · Fertility and Sterility · doi:10.1016/j.fertnstert.2018.01.037 · Cited by 64 · see citing works
Noninvasive biomarkers of endometriosis: myth or reality?
Lanišnik Rižner, T. (2014) · Expert Review of Molecular Diagnostics · doi:10.1586/14737159.2014.899905 · Cited by 52 · see citing works
Effect of Dienogest therapy on the size of the endometrioma
Vignali, M., Belloni, G. M., Pietropaolo, G., Barbasetti Di Prun, A., Barbera, V., Angioni, S., & Pino, I. (2020) · Gynecological Endocrinology · doi:10.1080/09513590.2020.1725965 · Cited by 50 · see citing works
Dienogest therapy during the early stages of recurrence of endometrioma might be an alternative therapeutic option to avoid repeat surgeries
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Authors: Guo, S.-W.
Affiliations: Shanghai Jiao Tong University (CN)
Corresponding author: Guo, S.-W.
ORCID: Guo, S.-W.
Venue: Human Reproduction Update
Publisher: Oxford University Press (OUP)
Published: 2009-03-11
Volume: 15
Issue: 4
Pages: 441-461
ISSN: 1355-4786 (ISSN-L)
1460-2369
DOI: 10.1093/humupd/dmp007
OpenAlex: W2132577372
Cited by: 719
References: 139
Citations by year: 2026: 37 · 2025: 55 · 2024: 54 · 2023: 61 · 2022: 73 · 2021: 49 · 2020: 62 · 2019: 59 · 2018: 51 · 2017: 31 · 2016: 37 · 2015: 35 · 2014: 24 · 2013: 28 · 2012: 17
FWCI: 2.96
Type: journal article
Language: en
Open access: closed
Locations: Human Reproduction Update (publishedVersion)
PubMed (publishedVersion)
Funders: National Natural Science Foundation of China
Science and Technology Commission of Shanghai Municipality
Topics: Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords: endometriosis, endometriosis recurrence, recurrence risk factors, recurrence biomarkers, postoperative medication, recurrence mechanism, recurrence rate, endometriosis surgery, targeted interventions
MeSH terms: Danazol, Endometriosis, Estrogen Antagonists, Female, Humans, Gonadotropin-Releasing Hormone, Risk Factors, Time Factors, Biomarkers, Randomized Controlled Trials as Topic, Cyclooxygenase 2, Secondary Prevention

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