Abstract
Objective
The purpose of the study was to develop an easily applicable predictive model to predict
deep infiltrating endometriosis in patients with ovarian endometrioma.
Study design
We performed a retrospective analysis of 178 consecutive women with ovarian endometrioma
who underwent surgery, with histological confirmation and complete removal of endometriosis
in the Hospital Clinic of Barcelona. Several markers were prospectively obtained and
compared between the group of patients presenting deep infiltrating endometriosis
associated with ovarian endometrioma and women with only ovarian endometrioma. Multiple
logistic regression analysis was performed to create a model to predict the presence
of deep infiltrating endometriosis and internal validation was later performed.
Results
Of the 178 patients studied, 80 (45%) were classified in the ovarian endometrioma
group and 98 (55%) in the group of patients presenting deep infiltrating endometriosis
associated with ovarian endometrioma. The independent variables to predict deep infiltrating
endometriosis were: at least one previous pregnancy, a past history of surgery for
endometriosis and the mean endometriosis-associated pelvic pain score. The area under
the ROC curve was 0.91 (95% confidence interval: 0.86–0.94), with an optimal cut-off
of the predicted probability of 0.54. The sensitivity of the model was 80% and the
specificity 84%.
Conclusions
This model predicts the development of deep infiltrating endometriosis in patients
with ovarian endometriomas allowing prioritization of women for referral to specialized
centers.
Keywords
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Article info
Publication history
Published online: November 26, 2015
Accepted:
November 18,
2015
Received in revised form:
November 17,
2015
Received:
August 19,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. All rights reserved.
