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Can postoperative GnRH agonist treatment prevent endometriosis recurrence? A meta-analysis.
- Source :
- Archives of Gynecology & Obstetrics; Jul2016, Vol. 294 Issue 1, p201-207, 7p
- Publication Year :
- 2016
-
Abstract
- <bold>Purpose: </bold>To investigate whether postoperative GnRH agonist (GnRH-a) treatment can prevent endometriosis recurrence.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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. [ABSTRACT FROM AUTHOR]
- Subjects :
- TREATMENT of endometriosis
DISEASE relapse
META-analysis
POSTOPERATIVE period
CONTROL groups
DISEASE relapse prevention
CLINICAL trials
COMBINED modality therapy
COMPARATIVE studies
ENDOMETRIOSIS
GYNECOLOGIC surgery
GONADOTROPIN releasing hormone
RESEARCH methodology
MEDICAL cooperation
RESEARCH
EVALUATION research
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 09320067
- Volume :
- 294
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Archives of Gynecology & Obstetrics
- Publication Type :
- Academic Journal
- Accession number :
- 116147029
- Full Text :
- https://doi.org/10.1007/s00404-016-4085-y