Persisting cyclic ovarian activity in cervical cancer after surgical transposition of the ovaries and pelvic irradiation

Bieler, E. U.; Schnabel, Thomas; Knobel, J

doi:10.1259/0007-1285-49-586-875

Cited by 29 publications

(7 citation statements)

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“…Of the 36 patients who did not receive adjuvant pelvic radiotherapy, 2 (5.5%) became postmenopausal, whereas 5 (28%) of the patients who received adjuvant pelvic radiotherapy became postmenopausal. This is consistent with several other studies which report a postmenopausal rate in irradiated patients with LOT of 0% to 30% (6)(7)(8)(9)11) . We also calculated the scatter radiation dose to the ovary in radiated patients and there seemed to be a tendency to become postmenopausal if the dose to the ovary exceeds 300 cGy.…”

Section: Discussionsupporting

confidence: 93%

“…Several studies have described follow-up results of patients with transposed ovaries (5)(6)(7)(8)(9)(10)(11)(12) . Three of them reported an increase in the incidence of symptomatic ovarian cyst formation of up to 25% in cervical cancer patients who underwent radical hysterectomy with pelvic lymphadenectomy and LOT, compared to patients who underwent radical hysterectomy with pelvic lymphadenectomy without LOT (5)(6)(7) .…”

mentioning

confidence: 99%

“…Three of them reported an increase in the incidence of symptomatic ovarian cyst formation of up to 25% in cervical cancer patients who underwent radical hysterectomy with pelvic lymphadenectomy and LOT, compared to patients who underwent radical hysterectomy with pelvic lymphadenectomy without LOT (5)(6)(7) . Also, the postmenopausal rate in irradiated patients with LOT varied from 0% to 30% (6)(7)(8)(9)11) .…”

mentioning

confidence: 99%

“…Six other studies have also examined the sequelae of LOT in irradiated cervical cancer patients (7)(8)(9)(10)(11)(12) . Five studies reported no ovarian cyst formation (8)(9)(10)(11)(12) . However, in three of these studies, the follow-up time after adjuvant pelvic radiotherapy was either less then 20 months or not reported (8,9,11) .…”

mentioning

confidence: 99%

“…Five studies reported no ovarian cyst formation (8)(9)(10)(11)(12) . However, in three of these studies, the follow-up time after adjuvant pelvic radiotherapy was either less then 20 months or not reported (8,9,11) . In the other two studies, the mobilization of the ovaries was less extensive (10,12) .…”

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confidence: 99%

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Benefits and side effects of lateral ovarian transposition (LOT) performed during radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer

Eijkeren¹,

Wijk²,

Sharouni

et al. 1999

Int J Gynecol Cancer

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Ovarian function and ovarian cyst formation after radical hysterectomy and pelvic lymphadenectomy with lateral ovarian transposition (LOT) have been retrospectively examined in 54 patients with early stage cervical cancer (FIGO IB or IIA) with a follow-up of 3-7 years. Patients were divided into two groups: those without adjuvant pelvic radiotherapy (36 patients) and those with adjuvant pelvic radiotherapy (18 patients). Ninety-one percent (33/36) of the patients without adjuvant pelvic radiotherapy and 66% (12/18) of the patients with adjuvant pelvic radiotherapy remained without evidence of recurrent disease. Of the 36 patients who did not receive adjuvant pelvic radiotherapy, only two patients became postmenopausal (5.5%). However, of the 18 patients who also received adjuvant pelvic radiotherapy, 5 became postmenopausal (28%). There was a tendency to become postmenopausal if the scatter radiation dose at the transposed ovaries was 300 cGy or more, but our series is too small to allow a definite conclusion. This scatter radiation dose did not depend on the distance the ovaries were placed from the linea innominata, because of the variation in the level of the cranial border of the radiation field. Three out of 54 patients (5.5%) developed symptomatic ovarian cysts, of which 2 required surgical intervention because of pain symptoms. Remarkably, in one of them cyst formation occurred 5 years after surgery. Of the 3 patients with symptomatic ovarian cysts this was the only patient who received adjuvant pelvic radiotherapy. From these data it can be concluded that LOT protects ovarian function in most patients undergoing radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer, even if they receive adjuvant pelvic radiotherapy, with an acceptable risk of development of symptomatic ovarian cysts.

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Section: Discussionsupporting

confidence: 93%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Benefits and side effects of lateral ovarian transposition (LOT) performed during radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer

Eijkeren¹,

Wijk²,

Sharouni

et al. 1999

Int J Gynecol Cancer

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Ovarian metastases from stage IB adenocarcinoma of the cervix

Mann

Chumas

Amalfitano

et al. 1987

Cancer

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At the time carcinoma of the cervix is treated by radical surgery, it is believed that ovarian preservation is possible, and will prevent surgical menopause, with its risks of osteoporosis, vaginal dryness, and "hot flashes." However, the data originally used to justify ovarian preservation was based on clinical experience with squamous cell carcinoma of the cervix. Little if any data exist to justify this treatment rationale in patients with adenocarcinoma of the cervix. Two patients who presented with clinical Stage IB adenocarcinoma of the cervix, subsequently underwent radical surgical treatment. Pathologic review of the operative specimens revealed microscopic metastasis to the ovaries in both patients. It is suggested that ovarian preservation at the time of radical surgical treatment for adenocarcinoma of the cervix has not had its safety established, and that sacrificing the ovaries and providing hormonal replacement postoperatively may be a safer course.

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Local therapy in stage I clear cell adenocarcinoma of the vagina

Senekjian

Frey

Anderson

et al. 1987

Cancer

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Of the 219 cases of Stage I vaginal clear cell adenocarcinoma reviewed, 176 had conventional therapy and 43 underwent local therapy. The two groups appear to be similar with respect to symptoms, stage, location of the lesion in the vagina, greatest tumor diameter, surface area, depth of invasion, predominant histologic pattern, grade, and number of mitoses; nonetheless, firm conclusions cannot be drawn because of missing data. Actuarial survival rates at 5 and 10 years for the local therapy group (92% and 88%, respectively) were essentially equivalent to those for the conventional therapy group (92% and 90%, respectively), however, the recurrence experience after local therapy was less favorable. Local therapy consisted of vaginectomy in nine cases, local excision alone in 17 cases, and local irradiation (with or without local excision) in 17 cases. The subgroup of patients receiving local irradiation had a recurrence experience as favorable as that of the conventional therapy group and more favorable than that of either the subgroup treated with vaginectomy or local excision alone. The data suggest that when employed, local therapy should include local irradiation.

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Persisting cyclic ovarian activity in cervical cancer after surgical transposition of the ovaries and pelvic irradiation

Cited by 29 publications

References 10 publications

Benefits and side effects of lateral ovarian transposition (LOT) performed during radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer

Benefits and side effects of lateral ovarian transposition (LOT) performed during radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer

Ovarian metastases from stage IB adenocarcinoma of the cervix

Local therapy in stage I clear cell adenocarcinoma of the vagina

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