title: Underuse of ovarian transposition in reproductive-aged cancer patients treated by primary or adjuvant pelvic irradiation.
abstract: OBJECTIVE
  To investigate the application status of ovarian transposition (OT) in reproductive-aged cancer patients undergoing radiation therapy.
  
  
  METHODS
  Between November 1999 and December 2008, 2524 patients had received pelvic irradiation at Seoul National University Hospital. We filtered the patients with the indications of (i) within 12 to 40 years of age, and (ii) receiving primary or adjuvant pelvic irradiation. There were 241 patients within 12 to 40 years of age. After excluding 133 patients with metastatic disease or under palliative radiation treatment, 108 patients were discovered appropriate for OT. We analyzed the application status of OT, surgical types of OT, cancer types and radiation types in those 108 patients.
  
  
  RESULTS
  Cervical cancer was the major indication (n = 68, 62.9%). Another 37.1% of indicated disease were composed of rectal cancer (n = 19), vulvo-vaginal cancer (n = 4), non-Hodgkin's lymphoma (n = 3), and other pelvic tumors (n = 14). Among the 108 patients, only 31 (28.7%) patients had received OT before pelvic irradiation. Most of the operations were applied on cervical cancer patients (n = 29) and only two procedures on rectal and endometrial cancer, respectively. OT had been mostly performed during laparotomy. Laparoscopic procedure was applied in only one case with advanced cervical cancer.
  
  
  CONCLUSIONS
  Although OT could be a preventive measure of premature ovarian failure from radiation therapy, this procedure has been considerably underused at our institution. This procedure should be applied more widely to preserve the fertility and improve the quality of life in reproductive-aged cancer patients.
authors: Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, Seoul, Korea.
authors: Seung-Su
authors: SS
authors: Han
authors: Yun Hwan
authors: YH
authors: Kim
authors: Sang-Hoon
authors: SH
authors: Lee
authors: Gwang Jun
authors: GJ
authors: Kim
authors: Hak Jae
authors: HJ
authors: Kim
authors: Jae Weon
authors: JW
authors: Kim
authors: Noh-Hyun
authors: NH
authors: Park
authors: Yong-Sang
authors: YS
authors: Song
authors: Soon-Beom
authors: SB
authors: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D059247:Fertility Preservation / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000532:radiotherapy*; D016649:Primary Ovarian Insufficiency / Q000517:prevention & control*; D011835:Radiation Protection; D056910:Republic of Korea; D012189:Retrospective Studies; D055815:Young Adult