Age and duration of hormonal therapy affect the recurrence of ovarian endometrioma after conservative surgery: a retrospective analytical observational study

Introduction: Ovarian endometrioma has a significantly high recurrence rate after surgery. Postoperative hormonal therapy may be useful in preventing recurrence. This study assesses recurrence rates, timing, and risk factors for patients with ovarian endometrioma who had conservative surgery and received hormonal therapy for ≤6 months and >6 months. Methods: A retrospective study involved 111 endometriosis patients who underwent conservative surgery, divided into two groups based on postoperative hormonal therapy duration (≤6 months and >6 months). Recurrence rates, time to recurrence, and influencing factors were documented. Results: The cumulative recurrence rate was 35.1% (39 patients) postoperatively in the first 24 months. Patients receiving hormonal therapy for ≤6 months had a 41.6% recurrence rate with a median recurrence at 14 months, while those with therapy for >6 months had a 9.1% recurrence rate with a median recurrence at 24 months. Significant recurrence factors included age at surgery (p = 0.006, OR 0.89, 95% CI 0.83 - 0.97), prior surgery history (p = 0.010, OR 4.94, 95% CI 1.46 - 16.78), therapy duration (p = 0.005, OR 11.04, 95% CI 2.04 - 59.65), and surgical technique (p = 0.001, OR 6.042, 95% CI 2.17 - 16.79). BMI, bilaterality, and cyst size were not statistically significant. Conclusion: Younger age at surgery and prior surgical history correlate with a higher recurrence rate, and long-term postoperative hormonal therapy (> 6 months) and laparoscopy decrease the recurrence rate.