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Meta-analysis identifies preoperative tumor size and count as key predictors for recurrence following laparoscopic myomectomy in womenLarge fibroids and many fibroids raise recurrence risk after myomectomy surgery

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Key Takeaway
Large fibroids and multiple tumors significantly increase recurrence risk after laparoscopic myomectomy, guiding preoperative risk assessment and patient counseling.

This comprehensive meta-analysis examined data from 2160 patients who underwent laparoscopic myomectomy to determine predictors of uterine leiomyoma recurrence. The study focused on identifying preoperative characteristics that might influence the likelihood of the condition returning after surgical intervention.

Analysis of the collected data highlighted that preoperative uterine leiomyoma size greater than or equal to 10 cm serves as a significant risk factor for recurrence. Similarly, a uterine size exceeding 10 or 14 weeks also demonstrated a strong association with higher recurrence rates. These findings suggest that tumor burden plays a critical role in postoperative outcomes.

The presence of two or more preoperative uterine leiomyomas was another major predictor identified in the research. Patients with multiple fibroids faced a substantially elevated risk of recurrence compared to those with fewer lesions. Conversely, factors such as age, BMI, and postoperative pregnancy did not show statistically significant associations with recurrence in this analysis.

The study provides a valuable reference for identifying high-risk groups before surgery. By fully evaluating these specific risk factors, clinicians can better predict recurrence and tailor patient counseling accordingly. Long-term follow-up data remains limited, but these insights offer a solid basis for clinical decision-making.

This meta-analysis examined data from 2160 patients who underwent laparoscopic myomectomy for uterine leiomyoma. The researchers looked at various patient characteristics to see which ones were linked to the fibroids coming back during follow-up periods of more than 12 months.

The study found that having a large fibroid before surgery was a strong predictor of recurrence. Specifically, a preoperative fibroid size of 10 centimeters or greater was associated with a higher risk. Similarly, a uterine size larger than 10 or 14 weeks and having two or more fibroids were also linked to an increased chance of the condition returning.

Other factors like age, body mass index, or future pregnancy plans did not show a statistically significant connection to recurrence in this analysis. The study provides a reference for clinicians to identify high-risk groups before surgery. However, the authors note there is no clear consensus on long-term follow-up data for this condition. Readers should understand these findings show associations rather than proving direct causes.

What this means for you:
Large fibroids and multiple fibroids are linked to higher recurrence risk after laparoscopic myomectomy.

Study Details

Study typeMeta analysis
Sample sizen = 2,160
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
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.
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