Meta-analysis identifies preoperative tumor size and count as key predictors for recurrence following laparoscopic myomectomy in women

BACKGROUND: There is still no clear consensus on long-term follow-up data for uterine leiomyoma (UL) recurrence and the major risk factors for recurrence after UL resection. This study aimed to investigate UL recurrence and related factors after laparoscopic myomectomy (LM). METHODS: The local and international literature on UL recurrence rates and related factors after LM was systematically collected, with the search period up to December 31st, 2024. Stata 16.0 software was used for meta-analysis. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model with the Hartung-Knapp-Sidik-Jonkman adjustment, regardless of the Ivalue. RESULTS: A total of eight studies were included, and 2,160 patients receiving LM were followed up for more than 12 months. The total number of recurrence cases was 497, and the crude recurrence rate was 23.0%. The meta-analysis results indicated that preoperative UL size ≥ 10 cm (OR = 2.15,  < 0.001), uterine size >10 or 14 weeks (OR = 2.40,  = 0.001), and preoperative UL number ≥2 (OR = 2.46,  < 0.001) were risk factors for UL recurrence after LM. There was no statistically significant association between age ≥35 years, BMI ≥ 24 or 25 kg/m, postoperative delivery or pregnancy, and post-LM UL recurrence. CONCLUSIONS: In this study, the risk factors for UL recurrence after LM were obtained through meta-analysis, which is more stable and reliable than the results of a single study and can provide a reference and basis for clinically identifying the risk factors related to LM recurrence after surgery, fully evaluating the risk of recurrence before surgery and predicting high-risk groups.