Ovarian transposition for patients with cervical carcinoma treated by radiosurgical combination.
OBJECTIVE
To assess the indications, effectiveness, and complications of ovarian transposition before pelvic irradiation for cervical cancer.


METHODS
Prospective study.


METHODS
Gynecologic oncology department at a French cancer center.


METHODS
One hundred seven patients treated for cervical cancer.


METHODS
Ovarian transposition to the paracolic gutters with radical hysterectomy and lymphadenectomy.


METHODS
Clinical and laboratory follow-up tests for ovarian function.


RESULTS
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.


CONCLUSIONS
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.
Morice
P
P
Institut Gustave Roussy, Villejuif, France.
Juncker
L
L
Rey
A
A
El-Hassan
J
J
Haie-Meder
C
C
Castaigne
D
D
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007044:Hysterectomy; D009367:Neoplasm Staging; D010053:Ovary / Q000502:physiology / Q000601:surgery*; D011182:Postoperative Care; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000601:surgery*