[Transposed ovarian function conservation in cervical cancer patients with radiotherapy]

Abstract

Objective: To evaluate the transposed ovarian function and complications in cervical cancer patients with postoperative pelvic radiotherapy.

Methods: Sixty-two women with stage I-IIa cervical cancer were treated with radical hysterectomy and pelvic lymphadenectomy and transposition of both ovaries to paracolic gutters from 1997 to 2003 at the Cancer Hospital of Fudan University. Menopausal symptoms, levels of follicle-stimulating hormone (FSH) and E2 were evaluated to assess ovarian function.

Results: Of 31 patients with stage IIa or poorly differentiated tumor or tumor > or = 2 cm in diameter, preoperative vaginal radiation was employed to deliver a dose of 15 Gy at point A. Postoperative pelvic radiation was performed in 15 patients. Totally 20% (6/30) of patients undergoing ovaries transposition without any radiation experienced ovarian failure within a mean of 15.7 months. In 35% (6/17) of patients with preoperative vaginal radiation, ovarian failure occurred within a mean of 12.0 months. When patients receiving postoperative pelvic radiation and ovaries transposition were considered together, 64% (9/14) experienced ovarian failure within a mean of 9.2 months (P < 0.05). Only 2 (3%) patients had cysts in transposed ovaries not requiring further surgery. There was no metastasis of the ovaries.

Conclusions: Lateral ovarian transposition is safe to patients with early stage cervical cancer. Both pre- and post-operative radiation significantly damages the ovarian function. Even ovaries transposition procedure also reduces the effectiveness.