Epidemiological aspects of the outcomes from the treatment of endometriosis: Experience from two different geographical areas

Charoula Matalliotaki; Michail Matalliotakis; Maria I Zervou; Athina Patelarou; Ioannis Koliarakis; Demetrios A Spandidos; Aydin Arici; Ioannis Matalliotakis; George N Goulielmos

doi:10.3892/etm.2019.8296

Epidemiological aspects of the outcomes from the treatment of endometriosis: Experience from two different geographical areas

Exp Ther Med. 2020 Feb;19(2):1079-1083. doi: 10.3892/etm.2019.8296. Epub 2019 Dec 5.

Authors

Charoula Matalliotaki¹, Michail Matalliotakis¹, Maria I Zervou², Athina Patelarou³, Ioannis Koliarakis⁴, Demetrios A Spandidos⁵, Aydin Arici⁶, Ioannis Matalliotakis¹, George N Goulielmos²

Affiliations

¹ Department of Obstetrics and Gynecology, Venizeleio General Hospital, 71409 Heraklion, Greece.
² Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece.
³ Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece.
⁴ Laboratory of Anatomy Histology Embryology, Medical School, University of Crete, 71003 Heraklion, Greece.
⁵ Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece.
⁶ Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA.

Abstract

The purpose of the present study was two-fold: First to review the epidemiological aspects of the experience on the surgical outcomes via laparotomy or laparoscopy, as regards endometriosis from two different academic institutions and, second, to illustrate potential differences in two different geographical areas, New Haven (US) and Greece. This retrospective study included 1,200 patients (15-80 years of age) treated via laparotomy or laparoscopy, at two different institutions, for endometriosis, between 1990 and 2017. Data were collected and analyzed from medical and pathological reports. The statistical methods used included the Student's t-test and χ² test, as well as the Mann-Whitney U test. A total of 600 women from Yale University and 600 women from Greece participated in this study. Endometrioma was confirmed in 359 (29.9%) cases. Women were compatible in terms of the site of endometriomas. Left-sided cysts were observed (P<0.001) significantly more often compared with right-sided cysts in both groups. The two groups of patients had similar rates of endometriosis stages. A statistically significant positive association (P<0.001) was found for the co-existence of benign gynecological tumors (apart from endometrioma), endometriosis-associated ovarian cancer and for post-menopausal endometriosis in women with endometriosis from Greece. Moreover, similar results were observed as regards endometriosis following in utero exposure to diethylstilbestrol (DES), non-Hodgkin's lymphoma, endometriosis-associated Lyme disease, human immuno-deficiency virus (HIV), melanoma and endometriosis in adolescents, between the two groups. To conclude, the two populations exhibited similar results as regards the surgical outcomes of endometriosis laparoscopic or open surgery. Endometriosis represents a multifactorial entity that depends on complex interactions of hormonal, genetic, immunological and environmental factors. Gynecologists should be aware that there is an association between endometriosis and cancerous diseases. It is thus suggested that the presence of comorbidities in women with endometriosis.

Keywords: endometrioma; endometriosis-associated ovarian cancer; postmenopausal endometriosis.