Association between the location of transposed ovary and ovarian function in patients with uterine cervical cancer treated with (postoperative or primary) pelvic radiotherapy

Capsule:
Location of the transposed ovary higher than 1.5 cm above the iliac crest is recommended to avoid ovarian failure after lateral ovarian transposition after primary or adjuvant pelvic radiotherapy.

Authors:
Jong Ha Hwang, M.D., Ph.D., Heon Jong Yoo, M.D., Sae Hyun Park, M.D., Myong Cheol Lim, M.D., Ph.D., Sang-Soo Seo, M.D., Ph.D., Sokbom Kang, M.D., Ph.D., Joo-Young Kim, M.D., Ph.D., Sang-Yoon Park, M.D., Ph.D.
Volume 97, Issue 6 , Pages 1387-1393.e2, June 2012

Objective:
To evaluate the effectiveness of ovarian transposition procedures in preserving ovarian function in relation to the location of the transposed ovaries in patients who underwent surgery with or without pelvic radiotherapy.

Design:
Retrospective.

Setting:
Uterine cancer center.

Patient(s):
A total of 53 patients with cervical cancer who underwent ovarian transposition between November 2002 and November 2010.

Intervention(s):
Ovarian transposition to the paracolic gutters with or without radical hysterectomy and lymph node dissection.

Main Outcome Measure(s):
Preservation of ovarian function, which was assessed by patient’s symptoms and serum FSH level.

Result(s):
Lateral ovarian transposition was performed in 53 patients. Based on receiver operator characteristic curve analysis, optimum cutoff value of location more than 1.5 cm above the iliac crest was significantly associated with preservation of ovarian function after treatment (area under receiver operator characteristic curve: 0.757, 95% confidence interval [CI]: 0.572–0.943). In univariate analysis, higher location of transposed ovary more than 1.5 cm from the iliac crest was the only independent factor for intact ovarian function (odds ratio 9.91, 95% CI: 1.75–56.3). Multivariate analysis confirmed that the location of transposed ovary (odds ratio 11.72, 95% CI 1.64–83.39) was the most important factor for intact ovarian function.

Conclusion(s):
Location of transposed ovary higher than 1.5 cm above the iliac crest is recommended to avoid ovarian failure after lateral ovarian transposition after primary or adjuvant pelvic radiotherapy in cervical cancer.

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