PLoS ONE (Jan 2021)

A prognostic index model for predicting long-term recurrence of uterine leiomyoma after myomectomy.

  • Xiu Ming,
  • Junying Zhou,
  • Jinhai Gou,
  • Na Li,
  • Dan Nie,
  • Luqi Xue,
  • Zhengyu Li

DOI
https://doi.org/10.1371/journal.pone.0254142
Journal volume & issue
Vol. 16, no. 7
p. e0254142

Abstract

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IntroductionUterine leiomyoma (UL) is a common benign pelvic tumor in women that has a high recurrence rate. Our aim is to propose a prognostic index (PI) model for predicting the long-term recurrence risk of uterine leiomyoma (UL).MethodsA total of 725 women who underwent myomectomy were enrolled in this retrospective multicenter study. Patients were contacted for follow-up. A PI model was proposed based on the multivariate Cox regression analysis in the model group. The predictive value of this model was tested in both internal and external validation group.ResultsPI formula = 1.5(if 3-5 leiomyomas) or 2(if >5 leiomyomas)+1(if residue)+1(if not submucosal)+1(if combined endometriosis). The PI value was divided into low-risk, intermediate-risk, and high-risk group by cut-off values 1.25 and 3.75. In the model group, the high-risk group had a significantly 4.55 times greater recurrence risk of UL than that in the low-risk group [cumulative recurrence rate (CR): 82.1% vs 29.5%, HR = 4.55, 95% CI 2.821-7.339]; the intermediate-risk group had a significantly 2.81 times greater recurrence risk of UL than that in the low-risk group (CR: 62.3% vs 29.5%, HR = 2.81, 95% CI 2.035-3.878). The differences between any two risk groups were also significant (PConclusionThe model was proved to be effective in predicting recurrence of UL after myomectomy.