Qiaomei Zheng1, Hongluan Mao1, Ying Xu1, Jing Zhao1, Xuan Wei1, Peishu Liu2. 1. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China. 2. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China. peishu_liu@126.com.
Abstract
PURPOSE: To investigate whether postoperative GnRH agonist (GnRH-a) treatment can prevent endometriosis recurrence. METHODS: This meta-analysis searched PubMed, Embase and Cochrane Library for relevant studies published online before June 2015. Seven randomized controlled trials including 328 patients with postoperative GnRH-a treatment and 394 patients in control group were included in the meta-analysis. In the meta-analysis, the recurrence rate of GnRH-a group compared with control group was evaluated with odds ratio (OR) and its 95 % confidence interval (CI). Heterogeneity, small study effect and publication bias were, respectively, assessed using Higgins I (2), sensitivity analysis and funnel plot. RESULTS: Postoperative GnRH-a treatment for endometriosis (pooled OR = 0.71; 95 % CI 0.52-0.96) was superior to expectant or placebo treatment in prevention of the recurrence. The recurrence rate decreased significantly in patients who received 6 months GnRH-a treatment (pooled OR = 0.59, 95 % CI 0.38-0.90), whereas no significant difference of recurrence rate existed between patients with 3 months post-surgical GnRH-a therapy and the control group (pooled OR = 0.87, 95 % CI 0.56-1.34). No significant heterogeneity and small study effect were found in the meta-analysis. However, publication bias did existed in the present meta-analysis. CONCLUSIONS: Longer-term (6 months) postoperative administration of GnRH-a can decrease the recurrence risk of endometriosis, whereas 3 months duration of GnRH-a therapy makes no significant difference in preventing the recurrence of endometriosis. Therefore, instead of a 3 month therapy, the duration of the postoperative administration should be longer enough (6 months) to prevent the recurrence of endometriosis.
PURPOSE: To investigate whether postoperative GnRH agonist (GnRH-a) treatment can prevent endometriosis recurrence. METHODS: This meta-analysis searched PubMed, Embase and Cochrane Library for relevant studies published online before June 2015. Seven randomized controlled trials including 328 patients with postoperative GnRH-a treatment and 394 patients in control group were included in the meta-analysis. In the meta-analysis, the recurrence rate of GnRH-a group compared with control group was evaluated with odds ratio (OR) and its 95 % confidence interval (CI). Heterogeneity, small study effect and publication bias were, respectively, assessed using Higgins I (2), sensitivity analysis and funnel plot. RESULTS: Postoperative GnRH-a treatment for endometriosis (pooled OR = 0.71; 95 % CI 0.52-0.96) was superior to expectant or placebo treatment in prevention of the recurrence. The recurrence rate decreased significantly in patients who received 6 months GnRH-a treatment (pooled OR = 0.59, 95 % CI 0.38-0.90), whereas no significant difference of recurrence rate existed between patients with 3 months post-surgical GnRH-a therapy and the control group (pooled OR = 0.87, 95 % CI 0.56-1.34). No significant heterogeneity and small study effect were found in the meta-analysis. However, publication bias did existed in the present meta-analysis. CONCLUSIONS: Longer-term (6 months) postoperative administration of GnRH-a can decrease the recurrence risk of endometriosis, whereas 3 months duration of GnRH-a therapy makes no significant difference in preventing the recurrence of endometriosis. Therefore, instead of a 3 month therapy, the duration of the postoperative administration should be longer enough (6 months) to prevent the recurrence of endometriosis.
Authors: Stefanie Burghaus; Sebastian D Schäfer; Matthias W Beckmann; Iris Brandes; Christian Brünahl; Radek Chvatal; Jan Drahoňovský; Wojciech Dudek; Andreas D Ebert; Christine Fahlbusch; Tanja Fehm; Peter Martin Fehr; Carolin C Hack; Winfried Häuser; Katharina Hancke; Volker Heinecke; Lars-Christian Horn; Christian Houbois; Christine Klapp; Heike Kramer; Harald Krentel; Jan Langrehr; Heike Matuschewski; Ines Mayer; Sylvia Mechsner; Andreas Müller; Armelle Müller; Michael Müller; Peter Oppelt; Thomas Papathemelis; Stefan P Renner; Dietmar Schmidt; Andreas Schüring; Karl-Werner Schweppe; Beata Seeber; Friederike Siedentopf; Horia Sirbu; Daniela Soeffge; Kerstin Weidner; Isabella Zraik; Uwe Andreas Ulrich Journal: Geburtshilfe Frauenheilkd Date: 2021-04-14 Impact factor: 2.915