A nomogram of predicting of recurrence of ovarian endometrioma after surgery for a 5-year follow-up.

OBJECTIVE There is currently no consensus on the risk factors for recurrent ovarian endometrioma after surgery. This study aimed to identify independent risk factors and develop a clinical nomogram to predict postoperative recurrence.

METHODS A retrospective study was conducted on 589 patients who underwent ovarian endometrioma excision at a tertiary institute between March 2013 and December 2018. Clinical variables were compared between patients with and without recurrence using logistic multiple regression analysis to identify independent predictors. A nomogram was subsequently constructed and validated.

RESULTS Of the 589 patients, 82 (13.92%) experienced recurrence. Multivariate analysis identified five independent risk factors: younger age at surgery, longer duration of menstruation, higher dysmenorrhea severity (VRS-5 scores), larger endometrioma diameter, and fewer postoperative deliveries (p < 0.05). Based on these factors, a nomogram was developed, yielding an area under the curve (AUC) of 0.703 in the development cohort and 0.719 in the validation cohort. Calibration curves and decision curve analysis (DCA) demonstrated the model's good fit and clinical net benefit.

CONCLUSION Younger age, menstruation duration, dysmenorrhea severity, cyst diameter, and postoperative deliveries are key determinants of recurrence. The novel nomogram serves as a practical tool for clinicians to estimate risk and personalize postoperative management.