Predictive Value of Serum Vascular Endothelial Growth Factor Level for Postoperative Endometriosis Recurrence in Patients with Ovarian Endometriosis

Background: Postoperative recurrence remains a problem for endometriosis. The study aimed to study whether baseline serum vascular endothelial growth factor (VEGF) levels can predict postoperative endometriosis recurrence. Methods: We included 147 patients with ovarian endometriosis who received laparoscopic endometrioma excision and postoperative gonadotropin-releasing hormone agonist treatment with hormonal add-back therapy between 2017 and 2019 in a tertiary hospital. According to endometriosis recurrence within 2 years, the patients were divided into two groups and baseline serum VEGF level measured before the surgery were compared. Logistic regression was used to examine the association between baseline serum VEGF level and endometriosis recurrence, and the area under the receiver operating characteristic curve (AUC) was calculated to examine its predictive performance. Results: The mean age of the patients was 30.1 +/- 6.0 years with a duration of dysmenorrhea of 60.3 +/- 35.0 months before surgery, and the majority (88.4%) were with revised American Fertility Society (rAFS) stage III or IV. Eight (5.44%) patients had endometriosis recurrence within 2 years. Compared with patients without recurrence, patients with recurrence were significantly younger (25.9 +/- 4.3 vs. 30.3 +/- 6.0 years, p = 0.040) and had higher baseline serum VEGF levels (689.67 +/- 127.38 vs. 547.87 +/- 171.31 pg/mL, p = 0.023), but there was no difference in other baseline characteristics. Serum VEGF levels were significantly associated with endometriosis recurrence (odds ratio 1.008 per pg/mL increase, 95% confidence interval 1.001-1.014) after adjusting for other baseline characteristics. The AUC of serum VEGF levels for predicting postoperative endometriosis recurrence was 0.741 (95% confidence interval 0.594-0.887). Conclusions: Baseline serum VEGF level is an independent risk factor of postoperative endometriosis recurrence and might be useful for predicting endometriosis recurrence.