{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T21:26:57Z","timestamp":1792186017387,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the significance of perioperative levonorgestrel\u2010releasing intrauterine system (LNG\u2010IUS) and\/or gonadotropin\u2010releasing hormone agonists (GnRHa) as adjuvant therapy in preventing recurrences or progression of diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records were collected from patients diagnosed with adenomyosis who underwent uterus\u2010sparing surgeries from March 1, 2012 to December 31, 2018. The associations of perioperative adjuvant therapy with recurrence of disease and symptoms were analyzed with the Kaplan\u2013Meier method and proportional hazards models with hazard ratios (HRs) and 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 322 eligible patients were included, of whom 173 (58.1%) received perioperative adjuvant therapy. Perioperative adjuvant therapy (HR 0.44, 95% CI 0.22\u20130.91, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.022) and perioperative GnRHa therapy (HR 0.48, 95% CI 0.24\u20130.99, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.042) significantly reduced disease recurrence. No patient using perioperative LNG\u2010IUS therapy experienced recurrence. In the multivariate analysis, increased age (&gt;35\u00a0years at surgery) was the only risk factor for disease recurrence (HR 2.35, 95% CI 1.01\u20135.45, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.047).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Perioperative adjuvant therapy with GnRHa and\/or the LNG\u2010IUS can significantly reduce disease recurrence or progression for adenomyosis patients undergoing uterus\u2010sparing surgery. Older patients are more likely to experience disease recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13573","type":"journal-article","created":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T02:55:48Z","timestamp":1608864948000},"page":"119-126","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Adjuvant therapy in conservative surgery for adenomyosis"],"prefix":"10.1002","volume":"154","author":[{"given":"Xiaopei","family":"Chao","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochen","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanwen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pathology Peking Union Medical College Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"You","sequence":"additional","affiliation":[{"name":"Department of Pathology Peking Union Medical College Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4755-9894","authenticated-orcid":false,"given":"Jinghe","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14673"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2015.09.018"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2014.08.016"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.06.027"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmz049"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2020.01.017"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2007.07.006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-38474-6_3"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.01.032"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.17242.1"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2014.953055"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(01)01962-8"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.199.1.8633139"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14806"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2006.01.016"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(03)01070-6"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.10.025"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.03.046"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.07.014"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.07.1744"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S205561"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0995-2200"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12887"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.01.013"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-63065-w"}],"container-title":["International Journal of Gynecology &amp; 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