Cumulative recurrence rate and risk factors for recurrent abdominal wall endometriosis after surgical treatment in a single institution
Open accessAbstract
This study aimed to evaluate the cumulative recurrence rate and risk factors for recurrent abdominal wall endometriosis (AWE) after surgical treatment.A retrospective cohort study was conducted at a single gynecological surgery center between January 2004 and December 2020. Patients who were surgically treated and followed up for at least 6 months after surgery were selected.Eighteen patients with pathologically diagnosed AWE were included in this study. The median follow-up duration was 22.5 months (range, 6-106). The median age was 37 years (range, 22-48), and 33.3% of the patients were nulliparous. Among the patients included in our study, 55.6% complained of a mass with cyclic pain, and 27.8% had a palpable mass. In addition, 22.2% of patients experienced recurrence with 17.5±9.7 months of mean time to recurrence. The cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were 23.8% and 39.1%, respectively. There were no statistically significant risk factors for the recurrence of AWE, including postoperative medical treatment.The recurrence rate of AWE appears to be correlated with the follow-up duration. There was no statistically significant risk factor for the recurrence of AWE. Unlike ovarian endometriosis, postoperative hormonal treatment does not seem to lower the recurrence of AWE. The findings of the current study may help healthcare providers in counselling and managing patients with AWE.
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Written from the paper’s full text.
TL;DR
In a single-institution retrospective cohort of 18 patients with surgically treated abdominal wall endometriosis (AWE), recurrence occurred in 22.2% at a mean of 17.5±9.7 months, with cumulative recurrence rates of 23.8% at 24 months and 39.1% at 60 months. No statistically significant risk factors for recurrence were identified, including postoperative medical treatment.
Key findings
- Among 18 pathologically diagnosed AWE patients, 22.2% experienced recurrence; mean time to recurrence was 17.5±9.7 months.
- Kaplan-Meier cumulative recurrence rates were 23.8% at 24 months and 39.1% at 60 months after surgical treatment.
- No statistically significant risk factors for recurrent AWE were found, including mass size, cyclic symptoms, previous operation type, interval between recent surgery and AWE surgery, pre- or postoperative medical treatment, and association with ovarian endometrioma.
- One patient was diagnosed with clear cell carcinoma arising from AWE, with subsequent inguinal lymph node metastasis and recurrent disease despite surgery and adjuvant paclitaxel-carboplatin chemotherapy.
Methods
- Retrospective cohort study at a single gynecological surgery center between January 2004 and December 2020; patients surgically treated for AWE and followed for at least 6 months were included.
- Of 56 clinically diagnosed AWE patients, 34 underwent surgical treatment, and 18 were followed for at least 6 months and included in the analysis.
- Data were collected by medical chart review; categorical variables used chi-square and Fisher’s exact tests, quantitative variables used Mann-Whitney U test after Shapiro-Wilk normality testing, cumulative recurrence was assessed by Kaplan-Meier method, and Cox proportional hazards models were used for risk-factor analysis with p<0.2 for univariate entry and p<0.05 for significance.
Limitations
- Stated: the study was retrospective; the number of surgically treated patients followed for at least 6 months was too small to generalize the results.
- Stated: the tissue involved in AWE was not evaluated, which could be a possible risk factor for recurrence; many patients were lost to follow-up after surgical treatment, and postoperative medical treatment duration was often relatively short.
- Evident from the text: findings come from a single institution and a rare disease cohort, and one patient with clear cell carcinoma arising from AWE was included, which may limit applicability to typical AWE populations.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
- Findingown data
Mass size was not a risk factor for AWE recurrence.
“mass size, cyclic symptoms, previous operation type, interval between recent surgery and AWE surgery, pre- and postoperative medical treatment, and association with ovarian endometrioma were not risk factors for AWE recurrence in our study.”
Quote in the paperSubstantial claim - Findingown data
Association with ovarian endometrioma was not a risk factor for AWE recurrence.
“mass size, cyclic symptoms, previous operation type, interval between recent surgery and AWE surgery, pre- and postoperative medical treatment, and association with ovarian endometrioma were not risk factors for AWE recurrence in our study.”
Quote in the paperSubstantial claim - Findingown data
Previous operation type was not a risk factor for AWE recurrence.
“mass size, cyclic symptoms, previous operation type, interval between recent surgery and AWE surgery, pre- and postoperative medical treatment, and association with ovarian endometrioma were not risk factors for AWE recurrence in our study.”
Quote in the paperSubstantial claim - Findingown data
Preoperative medical treatment did not decrease recurrence of AWE.
“In the univariate analysis, preoperative and postoperative medical treatments did not decrease recurrence.”
Quote in the paperSubstantial claim - Findingown data
There were no statistically significant risk factors for recurrence of AWE.
“There were no statistically significant risk factors for the recurrence of AWE, including postoperative medical treatment.”
- Also stated in: § RESULTS · plain
“The results showed no statistically significant risk factors for the recurrence of AWE.”
- Also stated in: § DISCUSSION · plain
“Univariate analysis of risk factors for recurrent AWE showed no statistically significant factors”
Quote in the paperSubstantial claim - Also stated in: § RESULTS · plain
- Findingown data
No statistically significant differences in baseline characteristics were observed between patients with and without recurrence.
“To analyze the possible risk factors for recurrent AWE, baseline characteristics of the two groups (without recurrence and with recurrence groups) were compared, as shown in Table 2. No statistically significant differences were observed between the two groups.”
Quote in the paperNot a substantial claim - Findingown data
22.2% of patients experienced recurrence.
“In addition, 22.2% of patients experienced recurrence with 17.5±9.7 months of mean time to recurrence.”
- Also stated in: § RESULTS · plain
“In addition, 22.2% of patients experienced recurrence within a mean period of 17.5±9.7 months.”
Quote in the paperSubstantial claim - Also stated in: § RESULTS · plain
- Findingown data
The cumulative recurrence rate at 60 months after surgical treatment of AWE was 39.1%.
“The cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were 23.8% and 39.1%, respectively.”
- Also stated in: § RESULTS · plain
“Using the Kaplan-Meier method, the cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were calculated as 23.8% and 39.1%, respectively (Fig. 2).”
- Also stated in: § DISCUSSION · plain
“In the present study, we found that the cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were 23.8% and 39.1%, respectively.”
Quote in the paperSubstantial claim - Also stated in: § RESULTS · plain
- Findingown data
Cyclic symptoms were not a risk factor for AWE recurrence.
“mass size, cyclic symptoms, previous operation type, interval between recent surgery and AWE surgery, pre- and postoperative medical treatment, and association with ovarian endometrioma were not risk factors for AWE recurrence in our study.”
Quote in the paperSubstantial claim - Findingown data
The median follow-up duration was 22.5 months (range, 6-106).
“The median follow-up duration was 22.5 months (range, 6–106).”
- Also stated in: § RESULTS · plain
“The median follow-up duration was 22.5 months (range, 6–106).”
Quote in the paperNot a substantial claim - Also stated in: § RESULTS · plain
- Findingown data
Interval between recent surgery and AWE surgery was not a risk factor for AWE recurrence.
“mass size, cyclic symptoms, previous operation type, interval between recent surgery and AWE surgery, pre- and postoperative medical treatment, and association with ovarian endometrioma were not risk factors for AWE recurrence in our study.”
Quote in the paperSubstantial claim - Findingown data
Postoperative medical treatment was not a statistically significant risk factor for recurrence of AWE.
“There were no statistically significant risk factors for the recurrence of AWE, including postoperative medical treatment.”
- Also stated in: § DISCUSSION · plain
“In the univariate analysis, preoperative and postoperative medical treatments did not decrease recurrence.”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · plain
- Findingown data
The mean time to recurrence was 17.5±9.7 months.
“In addition, 22.2% of patients experienced recurrence with 17.5±9.7 months of mean time to recurrence.”
- Also stated in: § RESULTS · plain
“In addition, 22.2% of patients experienced recurrence within a mean period of 17.5±9.7 months.”
Quote in the paperNot a substantial claim - Also stated in: § RESULTS · plain
- Findingown data
The cumulative recurrence rate at 24 months after surgical treatment of AWE was 23.8%.
“The cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were 23.8% and 39.1%, respectively.”
- Also stated in: § RESULTS · plain
“Using the Kaplan-Meier method, the cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were calculated as 23.8% and 39.1%, respectively (Fig. 2).”
- Also stated in: § DISCUSSION · plain
“In the present study, we found that the cumulative recurrence rates at 24 and 60 months after surgical treatment of AWE were 23.8% and 39.1%, respectively.”
Quote in the paperSubstantial claim - Also stated in: § RESULTS · plain
- Findingown data
The study included 18 patients with pathologically diagnosed abdominal wall endometriosis.
“Eighteen patients with pathologically diagnosed AWE were included in this study.”
- Also stated in: § RESULTS · plain
“A total of 18 patients were recruited.”
Quote in the paperSubstantial claim - Also stated in: § RESULTS · plain
- Study design and conductown data
The duration of medical treatment was relatively short in many cases.
“We evaluated postoperative medical treatment as one of the possible risk factors for recurrence; however, in many cases, the duration of medical treatment was relatively short.”
Quote in the paperNot a substantial claim - Interpretationown data
The recurrence rate of AWE appears to be correlated with the follow-up duration.
“The recurrence rate of AWE appears to be correlated with the follow-up duration.”
- Also stated in: § DISCUSSION · hedged
“In conclusion, the recurrence rate of AWE appears to be correlated with follow-up duration.”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · hedged
- Study design and conductnone given
Most patients were lost to follow-up after surgical treatment.
“Third, most patients were lost to follow-up after surgical treatment.”
Quote in the paperNot a substantial claim - Study design and conductreasoning
The number of subjects was too small to generalize the results.
“Since AWE is a rare disease entity, the number of subjects who were surgically treated and followed up for at least 6 months in this study were too small to generalize the results.”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 4
- May combine two claims. 1
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataOne patient was diagnosed with clear cell carcinoma arising from AWE.
“Among our patients, one woman was diagnosed with clear cell carcinoma.”
- Also stated in: § MATERIALS AND METHODS · plain
“One patient diagnosed with clear cell carcinoma arising from AWE on postoperative biopsy was also included in our analysis.”
Quote in the paperNot a substantial claim- Also stated in: § MATERIALS AND METHODS · plain
May combine two claims.
Interpretationown dataPostoperative hormonal treatment does not seem to lower the recurrence of AWE, unlike ovarian endometriosis.
“Unlike ovarian endometriosis, postoperative hormonal treatment does not seem to lower the recurrence of AWE.”
- Also stated in: § DISCUSSION · hedged
“Unlike ovarian endometriosis, postoperative hormonal treatment does not seem to lower the recurrence of AWE.”
Quote in the paperSubstantial claim- Also stated in: § DISCUSSION · hedged
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe study did not evaluate the tissue involved in AWE.
“Second, we did not evaluate the tissue involved in AWE, which could be a possible risk factor for recurrence due to its retrospective nature.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductnone givenThe study was performed retrospectively.
“First, the current study was performed retrospectively.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe study was approved by the Institutional Review Board and the ethics committee of CHA Gangnam Medical Center.
“This study was approved by the Institutional Review Board and the ethics committee of CHA Gangnam Medical Center on the Use of Human Subjects in Research (2021-10-005-001).”
Quote in the paperNot a substantial claim
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In a prior retrospective study, mass size was not a risk factor for postoperative recurrence.
“Interestingly, mass size was not a risk factor for postoperative recurrence in the retrospective study by Kim et al.17”
From Risk Factors for Postoperative Recurrence of Cesarean Scar Endometriosis (2024) · cites this paper as [17]
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- Authors
- Kim, S. J., Choi, S. H., Won, S., Shim, S., Lee, N., Kim, M., Kim, M. K., Seong, S. J., & Kim, M.-L.
- Affiliations
- Department of Obstetrics and Gynecology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
- CHA University (KR)
- Corresponding author
- Kim, Mi-La
- ORCID
- Venue
- Yonsei Medical Journal
- Publisher
- XMLink
- Published
- 2022
- Volume
- 63
- Issue
- 5
- Pages
- 446
- ISSN
- 0513-5796 (ISSN-L)
- 1976-2437
- PMC
- PMC9086694
- OpenAlex
- W4226193980
- Semantic Scholar
- 53f9cbd0423eb136f6d18ee584b5bec78f1a137e
- Cited by
- 20
- References
- 21
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 6 · 2022: 1
- FWCI
- 3.16
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Yonsei Medical Journal (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- 日本結晶成長学会誌
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- abdominal wall endometriosis, recurrence, risk factors, surgical treatment, postoperative hormonal therapy, follow-up duration, cyclic pain, palpable mass
- MeSH terms
- Adult, Endometriosis, Female, Humans, Pain, Recurrence, Retrospective Studies, Risk Factors, Abdominal Wall
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