OBJECTIVE: To assess the indications, effectiveness, and complications of ovarian transposition before pelvic irradiation for cervical cancer. DESIGN: Prospective study. SETTING: Gynecologic oncology department at a French cancer center. PATIENT(S): One hundred seven patients treated for cervical cancer. INTERVENTION(S): Ovarian transposition to the paracolic gutters with radical hysterectomy and lymphadenectomy. MAIN OUTCOME MEASURE(S): Clinical and laboratory follow-up tests for ovarian function. RESULT(S): Bilateral ovarian transposition was achieved in 104 patients (98%). Twelve patients were lost to follow-up or excluded because of evolution of the disease. Preservation of ovarian function was achieved in 83% of the patients having follow-up. The rates of ovarian preservation were 100% for patients treated exclusively by surgery, 90% for patients treated by postoperative vaginal brachytherapy, and 60% for patients treated by postoperative external radiation therapy and vaginal brachytherapy. The main risk for ovarian failure was found in patients treated by external radiation therapy. CONCLUSION(S): Ovarian transposition is a safe and effective procedure for preserving ovarian function in patients treated by a radiosurgical combination. This procedure should be performed in patients <40 years of age with a small invasive cervical carcinoma (<3 cm) treated by initial surgery. In such selected cases, the risk of ovarian metastasis is low.
OBJECTIVE: To assess the indications, effectiveness, and complications of ovarian transposition before pelvic irradiation for cervical cancer. DESIGN: Prospective study. SETTING: Gynecologic oncology department at a French cancer center. PATIENT(S): One hundred seven patients treated for cervical cancer. INTERVENTION(S): Ovarian transposition to the paracolic gutters with radical hysterectomy and lymphadenectomy. MAIN OUTCOME MEASURE(S): Clinical and laboratory follow-up tests for ovarian function. RESULT(S): Bilateral ovarian transposition was achieved in 104 patients (98%). Twelve patients were lost to follow-up or excluded because of evolution of the disease. Preservation of ovarian function was achieved in 83% of the patients having follow-up. The rates of ovarian preservation were 100% for patients treated exclusively by surgery, 90% for patients treated by postoperative vaginal brachytherapy, and 60% for patients treated by postoperative external radiation therapy and vaginal brachytherapy. The main risk for ovarian failure was found in patients treated by external radiation therapy. CONCLUSION(S): Ovarian transposition is a safe and effective procedure for preserving ovarian function in patients treated by a radiosurgical combination. This procedure should be performed in patients <40 years of age with a small invasive cervical carcinoma (<3 cm) treated by initial surgery. In such selected cases, the risk of ovarian metastasis is low.
Authors: Jeremy Lewin; Justin Ming Zheng Ma; Laura Mitchell; Seline Tam; Natasha Puri; Derek Stephens; Amirrtha Srikanthan; Philippe Bedard; Albiruni Razak; Michael Crump; David Warr; Meredith Giuliani; Abha Gupta Journal: Support Care Cancer Date: 2017-02-02 Impact factor: 3.603