{"id":235,"title":"Quality of life improves after endometriosis surgery independent of #ENZIAN classification: a multicenter cohort study","title_zh":"子宫内膜异位症手术后生活质量改善，与#ENZIAN解剖学分类无关：一项多中心前瞻性队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42983411","doi":"10.1186/s12916-026-05136-9","pmid":"42983411","journal":"BMC Med","kind":"paper","lang":"en","published_at":"2026-08-07T00:00:00+00:00","fetched_at":"2026-11-08T03:44:00+00:00","authors":["Perricos-Hess A","Gstoettner M","Heinzl F","Reiser E","Buchweitz O","Jaekel M","Westphal E","Rimbach S","Woelfler M","Kraemer B","Kolben T","Pempelfort SD","Pashkunova D","Metzler J","Derihaci RP","Klein P","Janschek E","Guttenberg P","Wuester M","Wolfrum A","Seifert-Klauss V","Enzelsberger SH","Keckstein J","Seeber B","Wenzl R"],"primary_topic":"endometrium","topics":[{"slug":"endometrium","score":4.0,"hits":["endometriosis"]}],"topic_score":4.0,"preference_score":0.0,"preference_labels":[],"llm_score":72.0,"final_score":72.0,"score_dims":{"novelty":60,"rigor":82,"impact":66,"relevance":50,"translation":62},"recommend_reason":"大样本多中心前瞻性设计（n=627，随访12个月）提供了“解剖学分期不预测术后生活质量”的阴性证据，提示应结合患者报告结局（PRO）与症状负荷进行评估，对内异症手术咨询与结局导向决策有直接参考价值，但与ART/胚胎核心环节距离较远。","keywords":["子宫内膜异位症","#ENZIAN分类","生活质量","EHP-30","患者报告结局","手术治疗"],"selected":1,"story_id":458,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-uterus-pregnancy","source_name":"PubMed · 内膜/植入/早孕","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该多中心前瞻性队列研究纳入奥地利、德国、瑞士认证中心627例经手术及病理确诊的子宫内膜异位症女性（18-50岁），术中用#ENZIAN与rASRM系统分类病灶，术前及术后6、12个月用EHP-30评估生活质量。结果显示，术后6个月内生活质量显著且具临床意义的改善，并在12个月维持稳定；该改善在各#ENZIAN分区（包括深部浸润与多灶病变）中一致，解剖分布与rASRM分期不能预测基线生活质量或术后恢复轨迹，而基线症状负荷与手术完全切除是早期改善的最强预测因子。","summary":"BACKGROUND: Endometriosis is a chronic inflammatory disease associated with substantial impairment of quality of life. Although the #ENZIAN classification enables detailed anatomical characterization of disease distribution, its relevance for predicting patient-reported outcomes after surgery remains uncertain. Clarifying this relationship is essential for patient counseling and outcome-oriented surgical decision making. METHODS: This multicenter study, registered on ClinicalTrials.gov (NCT05624567), prospectively recruited consecutive women aged 18 to 50 years undergoing surgery for suspected endometriosis at certified endometriosis centers in Austria, Germany, and Switzerland. Only women with surgically and histopathologically confirmed endometriosis who completed the baseline Endometriosis Health Profile-30 (EHP-30) questionnaire were included in the final analysis. Disease localization was classified intraoperatively using the #ENZIAN and rASRM systems. Quality of life was assessed using the EHP-30 questionnaire preoperatively and at 6 and 12 months after surgery. Longitudinal changes and predictors of quality-of-life outcomes were analyzed using ordinal logistic regression models. RESULTS: A total of 627 women were included at baseline, with 430 and 325 completing 6- and 12-month follow-up, respectively. Surgical treatment was associated with a marked and clinically meaningful improvement in quality of life, with EHP-30 scores improving significantly within the first 6 months after surgery and remaining stable at 12 months. This improvement was observed consistently across all #ENZIAN compartments, including deep infiltrating and multifocal disease. Anatomical disease distribution and rASRM stage were not significantly associated with baseline quality-of-life or postoperative recovery trajectories. In contrast, baseline symptom burden and complete surgical resection emerged as the strongest predictors of early postoperative quality-of-life improvement. CONCLUSIONS: Surgical treatment of endometriosis was associated with substantial and sustained improvement in patient-reported quality of life, independent of anatomical disease distribution as classified by #ENZIAN. These findings suggest that meaningful postoperative benefit can be achieved across all disease localizations and underscore the importance of focusing on symptom severity and surgical completeness rather than anatomical staging alone. Incorporating patient-reported outcome measures alongside anatomical classification is essential for comprehensive evaluation of treatment success.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}