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The Prognostic Value of Individual Adhesion Scores from the Revised American Fertility Society Classification System for Recurrent Endometriosis

 Bo Hyon Yun  ;  Young Eun Jeon  ;  Seung Joo Chon  ;  Joo Hyun Park  ;  Seok Kyo Seo  ;  SiHyun Cho  ;  Young Sik Choi  ;  Ji Sung Lee  ;  Byung Seok Lee 
 YONSEI MEDICAL JOURNAL, Vol.56(4) : 1079-1086, 2015 
Journal Title
Issue Date
Adolescent ; Adult ; Cohort Studies ; Endometriosis/classification* ; Endometriosis/surgery* ; Female ; Fertility ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Laparoscopy/methods* ; Middle Aged ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors ; Tissue Adhesions* ; Treatment Outcome ; United States
Endometriosis ; ovarian adhesion ; prognostic factor ; rAFS classification ; recurrence
PURPOSE: This study aimed to evaluate the prognostic value of each component of the revised American Fertility Society (rAFS) classification system for the first recurrence of endometriosis after conservative laparoscopy. MATERIALS AND METHODS: As this was a retrospective cohort study, data were collected by reviewing medical records. A total of 379 women ages 18 to 49 years were included. Women who underwent conservative laparoscopy with histologic confirmation of endometriosis at Gangnam Severance Hospital between March 2003 and May 2010 were included. Individual components of the rAFS classification system as well as preoperative serum CA-125 levels were retrospectively analyzed to assess their prognostic values for recurrence of endometriosis. RESULTS: Of 379 patients, 80 (21.2%) were found to have recurrence of endometriosis. The median duration of follow-up was 19.0 months, and the mean age at the time of surgery was 31.8±6.7 years. In endometriosis of advanced stage, younger age at the time of surgery, bilateral ovarian cysts at the time of diagnosis, a rAFS ovarian adhesion score >24, and complete cul-de-sac obliteration were independent risk factors of poor outcomes, and a rAFS ovarian adhesion score >24 had the highest risk of recurrence [hazard ratio=2.948 (95% CI: 1.116-7.789), p=0.029]. CONCLUSION: Our results suggest that of the rAFS adnexal adhesion scores, the ovarian adhesion score rather than the tubal adhesion score was associated with a significantly increased risk of recurrent endometriosis. The preoperative serum CA-125 level may be also a significant prognostic factor for recurrence, as known. However, it seemed to only have borderline significance in affecting recurrence in the current study.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Park, Joo Hyun(박주현)
Seo, Seok Kyo(서석교) ORCID logo https://orcid.org/0000-0003-3404-0484
Yun, Bo Hyon(윤보현) ORCID logo https://orcid.org/0000-0001-5703-797X
Lee, Byung Seok(이병석) ORCID logo https://orcid.org/0000-0001-6001-2079
Jeon, Young Eun(전영은)
Cho, Si Hyun(조시현) ORCID logo https://orcid.org/0000-0003-2718-6645
Choi, Young Sik(최영식) ORCID logo https://orcid.org/0000-0002-1157-4822
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