Review of hydatid cyst cases and causes of recurrences complicating treatment, a 7-year cross-sectional study from Turkey: A single-center, retrospective observational study

Cystic echinococcosis (CE) is an endemic zoonotic disease in Turkey. Despite advances in treatment approaches, full eradication is not always possible. So, recurrence remains a major concern with a long-lasting silent-course necessitating close follow-up. Recurrence has higher morbidity and mortality requiring more complex treatment approaches. We aimed to evaluate the epidemiologic, laboratory data, treatment approaches, and their relationship with recurrence. This retrospective, cross-sectional study assessed patients with CE who were admitted to a training and research hospital between January 2015 and August 2021. Demographic, clinical characteristics, and laboratory findings of the patients were examined, and comparisons were made between those with and without recurrence. Multivariable logistic regression analysis was conducted to identify potential risk factors for CE recurrence. Of the total 214 patients with a mean age was 50.4 ± 16.5 years; 62.6% (n = 134) were female and 60.2 % (129) had a history of living in a rural area. The most common cyst localization was in the liver in 167 (78%). Although the diagnosis was confirmed by imaging methods in all patients, serological test positivity was found only in 72% (n = 140). Recurrence was seen in 17.8% (n = 38) of the patients, and recurrence most commonly occurred within the first 3 years in 25 patients (65.7%), 12 of whom (31.6%) experienced recurrence in the 1st year after treatment. The recurrence rate was higher in the patients with multiorgan involvement (odds ratios [OR] 2.5, 95% confidence interval [CI]: 1.1-5.6, P = .019), a hydatid cyst duration of more than 5 years (OR 5.5, 95% CI: 2.6-11.8, P < .001), and those who underwent invasive procedure (OR 4.6, 95% CI: 1.3-15.7, P = .014). Hydatid cyst duration > 5 years was an independent risk factor for the recurrence of CE (OR 3.5, 95% CI: 1.5-8.1, P = .003). CE is frequently seen in females, especially living in rural areas. It is difficult to diagnose with routine serological testing, so imaging techniques are needed for diagnosis. Although longer duration of the disease, multiorgan involvement, and invasive treatment were more in patients with recurrences, only the long duration of the disease was independently associated with recurrences. In addition, due to presence of very late recurrences, long-term follow-up is important.