Clinical predictors of postoperative recurrence in ovarian endometrioma: evaluation of follistatin expression

Year 2026, Volume: 7 Issue: 2, 381 - 385, 27.03.2026

Candost Hanedan , Sefa Kelekçi

https://izlik.org/JA98YD69WX

Abstract

Aims: To evaluate clinical predictors of postoperative recurrence in ovarian endometrioma and to investigate the association between epithelial follistatin immunohistochemical expression and recurrence after surgery.
Methods: This retrospective study included patients who underwent surgery for ovarian endometrioma between 2008 and 2013. Demographic, clinical, and surgical data and recurrence characteristics were analyzed. Follistatin expression in endometriotic glandular epithelial cells was assessed immunohistochemically using a binary scoring system (positive vs. negative). Factors associated with recurrence were evaluated statistically.
Results: Fifty patients were included, and recurrence occurred in 24 (48%). Advanced-stage disease was significantly more common in patients with recurrence (66.7% vs. 30.8%, p=0.034), and previous endometriosis surgery was markedly higher in the recurrence group (50.0% vs. 3.8%, p<0.001). Postoperative pregnancy occurred less frequently among patients with recurrence (8.3% vs. 30.8%, p=0.042). Bilateral disease showed a non-significant trend toward recurrence (p=0.08). Cytoplasmic epithelial follistatin staining was present in 28% of patients and was not associated with recurrence (p=0.860). ROC analysis showed no discriminative ability of follistatin staining for predicting recurrence (AUC=0.511; 95% CI: 0.349–0.673).
Conclusion: Postoperative recurrence of ovarian endometrioma appears to be mainly influenced by established clinical factors, whereas epithelial follistatin expression does not provide prognostic value for recurrence prediction.

Keywords

Ovarian endometrioma , endometriosis , recurrence , clinical predictors , follistatin , immunohistochemistry , fertility

Ethical Statement

This study was approved by the İzmir Katip Çelebi University Ethics Committee (Decision No: 250) and was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants.

Supporting Institution

This study was supported by the Scientific Research Projects Coordination Unit of İzmir Katip Çelebi University.

Project Number

Not available

Thanks

This manuscript was derived from the first author's medical specialty thesis and was supported by the Scientific Research Projects Coordination Unit of İzmir Katip Çelebi University.

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