Clinical Report: Creation and assessment of a nomogram for forecasting symptomatic recurrence post-laparoscopic adenomyomectomy

Overview

This study developed and validated a nomogram to predict symptomatic recurrence after laparoscopic adenomyomectomy in patients with adenomyosis. The nomogram demonstrated an area under the curve (AUC) of 0.776.

Background

Adenomyosis is a prevalent gynecologic condition affecting women of reproductive age. Uterine-sparing surgeries, such as laparoscopic adenomyomectomy, are alternatives for women seeking to preserve fertility, yet they carry a risk of symptomatic recurrence. Accurate prediction of recurrence is essential for guiding postoperative management.

Data Highlights

Key Findings

• The nomogram was based on a cohort of 484 patients who underwent laparoscopic adenomyomectomy.
• Symptomatic recurrence occurred in 131 patients, while 353 remained recurrence-free.
• Independent predictors of recurrence included previous surgical history of ovarian endometrioma and preoperative CA125 level.
• The nomogram achieved an AUC of 0.776, indicating good discriminatory ability.
• Calibration curves demonstrated good performance, and decision curve analysis indicated high net benefit for predicted probabilities between 0% and 60%.

Clinical Implications

The nomogram provides a tool for estimating the risk of symptomatic recurrence in patients post-laparoscopic adenomyomectomy.

Conclusion

The developed nomogram offers a promising approach for predicting symptomatic recurrence after laparoscopic adenomyomectomy, though further multicenter validation is necessary to confirm its clinical utility.

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