Selection of key recommendations for the management of women with endometriosis by an international panel of patients and professionals

Schleedoorn, Myra; Nelen, W.L.D.M.; Dunselman, G.A.J.; Vermeulen, Niki

doi:10.1093/humrep/dew078

Cited by 33 publications

(37 citation statements)

References 79 publications

(78 reference statements)

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“…Without this evaluation, good outcome measures do not necessarily stand for good quality of care, whereas the application of process and structural indicators in daily practice can lead to better outcome measures. 27 The second dimension identified by the MCA, the multidisciplinary management of EC, seems to be particularly relevant because one of the main difficulties in the management of EC is the general management of such patients in areas other than surgery. This QI was also proposed by the US initiative to attempt to understand the factors that gynecologic oncologists believe define quality.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Selection of Quality Indicators for the Management of Endometrial Cancer

Chenoz¹,

Phelippeau²,

Barranger³

et al. 2017

International Journal of Gynecological Cancer

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Section: Discussionmentioning

confidence: 99%

Evaluation and Selection of Quality Indicators for the Management of Endometrial Cancer

Chenoz¹,

Phelippeau²,

Barranger³

et al. 2017

International Journal of Gynecological Cancer

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“…Women with endometriosis suffer from pelvic pain, painful periods, pain at sexual intercourse, and subfertility . Treatment options are limited to repeated surgeries or hormonal intervention, which is often associated with adverse effects similar to a premature menopause . Different general etiological concepts of endometriosis include retrograde menstruation, coelomic metaplasia, lymphovascular metastasis, or the embryonic rest theory, but the underlying molecular mechanisms remain unclear, impeding the development of targeted therapies …”

Section: Introductionmentioning

confidence: 99%

“…1 Treatment options are limited to repeated surgeries or hormonal intervention, which is often associated with adverse effects similar to a premature menopause. 1,2 Different general etiological concepts of endometriosis include retrograde menstruation, coelomic metaplasia, lymphovascular metastasis, or the embryonic rest theory, but the underlying molecular mechanisms remain unclear, impeding the development of targeted therapies. 1,2 Mechanisms relating to the pathogenesis of endometriosis include altered inflammation and proteolysis, endocrine alterations, as well as epigenetic modifications such as microRNA dysregulation.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Different general etiological concepts of endometriosis include retrograde menstruation, coelomic metaplasia, lymphovascular metastasis, or the embryonic rest theory, but the underlying molecular mechanisms remain unclear, impeding the development of targeted therapies. 1,2 Mechanisms relating to the pathogenesis of endometriosis include altered inflammation and proteolysis, endocrine alterations, as well as epigenetic modifications such as microRNA dysregulation. [2][3][4][5] Notably, all classical concepts of endometriosis fit to an altered endometrial stem cell function.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Mechanisms relating to the pathogenesis of endometriosis include altered inflammation and proteolysis, endocrine alterations, as well as epigenetic modifications such as microRNA dysregulation. [2][3][4][5] Notably, all classical concepts of endometriosis fit to an altered endometrial stem cell function. [5][6][7] For instance, the key role of stem cells during development may contribute to the process of coelomic metaplasia.…”

Section: Introductionmentioning

confidence: 99%

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γ‐Secretase inhibition affects viability, apoptosis, and the stem cell phenotype of endometriotic cells

Williams

Brüggemann

Hubert

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Stem cells mediate cyclic regeneration of the endometrium. The upregulated expression of receptors and modulators of the notch signaling pathway in endometriosis suggests an involvement in the pathogenetic process. Here, we investigated the effects of notch pathway inhibition by a γ‐secretase inhibitor (GSI) on stemness‐associated properties of the epithelial endometriotic cell line 12Z and of primary endometriotic stroma cells. Material and methods 12Z cells and primary endometriotic stroma cells of 7 patients were treated with or without GSI, and analyzed for changes in gene expression by TaqMan low‐density arrays, quantitative PCR, and flow cytometry. The functional impact of GSI treatment was studied by MTT assay, cell cycle analysis, colony formation assay, annexin V apoptosis assay, and aldehyde dehydrogenase activity assays. Results In 12Z cells, GSI treatment reduced aldehyde dehydrogenase activity and colony formation, and induced a shift to the G2/M phase of the cell cycle. Cell viability was decreased and apoptosis was increased in both cell models. GSI further induced transcriptional downregulation of the stemness‐associated factors leukemia inhibitory factor receptor (LIFR), sex‐determining region Y (SRY)‐ box 2, interferon‐induced transmembrane protein 1, and hes‐related family bHLH transcription factor with YRPW motif 1, in 12Z cells and in primary cell cultures. Downregulation of LIFR expression by GSI was confirmed at the protein level by flow cytometry. Conclusions Our in vitro data suggest that application of GSI may be a worthwhile approach in the treatment of endometriosis that warrants further investigation.

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Treatment Patterns, Complications, and Health Care Utilization Among Endometriosis Patients Undergoing a Laparoscopy or a Hysterectomy: A Retrospective Claims Analysis

et al. 2017

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IntroductionHysterectomy and laparoscopy are common surgical procedures used for the treatment of endometriosis. This study compares outcomes for women who received either procedure within the first year post initial surgery.MethodsThe study used data from the Truven Health MarketScan claims databases from 2004 to 2013 to identify women aged 18–49 years who received an endometriosis-related laparoscopy or hysterectomy. Patients were excluded if they did not have continuous insurance coverage from 1 year before through 1 year after their endometriosis-related procedure, if they were diagnosed with uterine fibroids prior to or on the date of surgery (i.e., index date), or if they had a hysterectomy prior to the index date. The descriptive analyses examined differences between patients with an endometriosis-related laparoscopy or hysterectomy in regard to medications prescribed, complications, and hospitalizations during the immediate year post procedure.ResultsThe final sample consisted of 24,915 women who underwent a hysterectomy and 37,308 who underwent a laparoscopy. Results revealed significant differences between the cohorts, with women who received a laparoscopy more likely to be prescribed a GnRH agonist, progestin, danazol, or an opioid analgesic in the immediate year post procedure compared to women who underwent a hysterectomy. In contrast, women who underwent a hysterectomy generally had higher complication rates. Index hospitalization rates and length of stay (LOS) were higher for women who had a hysterectomy, while post-index hospitalization rates and LOS were higher for women who had a laparoscopy. For both cohorts, post-procedure complications were associated with significantly higher hospitalization rates and longer LOS.ConclusionThis study indicated significantly different 1-year post-surgical outcomes for patients who underwent an endometriosis-related hysterectomy relative to a laparoscopy. Furthermore, the endometriosis patients in this analysis had a considerable risk of surgical complications, subsequent surgeries, and hospital admissions, both during and after their initial therapeutic laparoscopy or hysterectomy.FundingAbbVie.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0619-3) contains supplementary material, which is available to authorized users.

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Selection of key recommendations for the management of women with endometriosis by an international panel of patients and professionals

Abstract: No funding was received for the conduct of this study. Members of the EndoKey study group did not receive payment. The authors and members of the EndoKey study group have no conflict of interest.

Cited by 33 publications

References 79 publications

Evaluation and Selection of Quality Indicators for the Management of Endometrial Cancer

Evaluation and Selection of Quality Indicators for the Management of Endometrial Cancer

γ‐Secretase inhibition affects viability, apoptosis, and the stem cell phenotype of endometriotic cells

Treatment Patterns, Complications, and Health Care Utilization Among Endometriosis Patients Undergoing a Laparoscopy or a Hysterectomy: A Retrospective Claims Analysis

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