Ovarian Transposition for Stage Ib Squamous Cell Cervical Cancer - Lack of Effects on Survival Rates?

Abstract

Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and Methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%) , OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS) . These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. P≤0.05 was considered to be statistically significant. Results: The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.

Association between the location of transposed ovary and ovarian dose in patients with cervical cancer treated with postoperative pelvic radiotherapy

“…Therefore, ovarian preservation in patients with cervical squamous cell carcinoma is recognized as safe and feasible, whereas in other pathological types it remains controversial. The ovary is located in the pelvis and is damaged by postoperative pelvic radiotherapy [7]. McCall et al first described the ovary transposition out of the pelvic radiation fields as an effective method to avoid radiation injury of ovaries during postoperative radiotherapy in 1958 [8].…”

Recurrent early-stage squamous cell carcinoma cervical cancer presenting with isolated ovary metastasis: a rare case report

“…Moreover, this improves young women’s quality of life by preventing them from severe menopausal symptoms, including immediate hot flashes, osteoporosis, and emotional problems. Therefore, maintaining normal ovarian endocrine function is crucial for young patients with early-stage cervical cancer 10 . Oophorectomy should be considered in patients with a high risk of ovarian cancer, such as BRCA1,2 mutation 11 .…”