Ovarian transposition for patients with cervical carcinoma treated by radiosurgical combination.

OBJECTIVE

To assess the indications, effectiveness, and complications of ovarian transposition before pelvic irradiation for cervical cancer.

DESIGN

Prospective study.

SETTING

Gynecologic oncology department at a French cancer center.

PATIENT(S): One hundred seven patients treated for cervical cancer.

INTERVENTION(S): Ovarian transposition to the paracolic gutters with radical hysterectomy and lymphadenectomy.

MAIN OUTCOME MEASURE(S): Clinical and laboratory follow-up tests for ovarian function.

RESULT(S): Bilateral ovarian transposition was achieved in 104 patients (98%). Twelve patients were lost to follow-up or excluded because of evolution of the disease. Preservation of ovarian function was achieved in 83% of the patients having follow-up. The rates of ovarian preservation were 100% for patients treated exclusively by surgery, 90% for patients treated by postoperative vaginal brachytherapy, and 60% for patients treated by postoperative external radiation therapy and vaginal brachytherapy. The main risk for ovarian failure was found in patients treated by external radiation therapy.

CONCLUSION(S): Ovarian transposition is a safe and effective procedure for preserving ovarian function in patients treated by a radiosurgical combination. This procedure should be performed in patients <40 years of age with a small invasive cervical carcinoma (<3 cm) treated by initial surgery. In such selected cases, the risk of ovarian metastasis is low.