Ablation and risk of recurrence in endometrioma: a systematic review and meta-analysis
Bibliographic record
Abstract
Objective.Ovarian endometriosis, or endometriomas, is a common manifestation and is typically treated via laparoscopic cystectomy.However, this method may compromise ovarian function.Ablation, involving thermal destruction of endometriosis cells, is emerging as an alternative.Despite some evidence suggesting less impact on ovarian function, there is a lack of robust data on the efficacy of ablation in preventing recurrence.This systematic review and meta-analysis aim to evaluate the recurrence rates of ablation compared to standard cystectomy for ovarian endometriomas. Materials and Methods.This study followed PRISMA guidelines and was registered with PROSPERO (protocol number CRD549177).Comprehensive searches were conducted in PubMed, EMBASE, Scopus, Google Scholar, ClinicalTrials.gov,and the Cochrane Central Register up to May 2024.Inclusion criteria focused on studies involving patients with at least one ovarian endometrioma treated with ablation or cystectomy, reporting recurrence rates, and having a minimum follow-up of 12 months.The studies were assessed for quality using the Newcastle-Ottawa Scale.Data were analyzed using fixed-effect or random-effect models based on heterogeneity, with statistical significance set at p < 0.05. Results.The search identified 58 articles, with 16 meeting the criteria for review.5 studies, encompassing 395 patients, were included in the final analysis.4 studies compared ablation and cystectomy.Recurrence rates varied, with ablation ranging from 0% to 37.7% and cystectomy from 0% to 22%.Meta-analysis revealed a non-significant trend toward higher recurrence rates with cystectomy (OR 1.99, 95% CI 0.95-4.16,p=0.07).The heterogeneity was low (I2=0%, p=0.45).Conclusions.This systematic review and meta-analysis did not find a statistically significant difference in recurrence rates between ablation and cystectomy for treating ovarian endometriomas.However, there was a non-significant trend favoring ablation.Further randomized controlled trials are necessary to confirm these findings and to better understand the long-term efficacy and safety of ablation compared to cystectomy. M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o n
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.040 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".