Department of Gynecology, Osaka International Cancer Institute, Osaka 541-8567, Japan.
Department of Forensic Medicine, School of Medicine, Kindai University, Osaka 589-8511, Japan.
Curr Oncol. 2022 Sep 29;29(10):7158-7170. doi: 10.3390/curroncol29100563.
In early-stage cervical cancer, ovarian metastasis is relatively rare, and ovarian transposition is often performed during surgery. Although rare, the diagnosis and surgical approach for recurrence at transposed ovaries are challenging. This study focused on the diagnosis and surgical management of transposed ovarian recurrence in cervical cancer patients. A 45-year-old premenopausal woman underwent radical hysterectomy, bilateral salpingectomy, and pelvic lymphadenectomy following postoperative concurrent chemoradiotherapy for stage IB1 cervical cancer. During the initial surgery, the ovary was transposed to the paracolic gutter, and no postoperative complications were observed. Ovarian recurrence was diagnosed using positron emission tomography-computed tomography, and a laparoscopic bilateral oophorectomy was performed. A systematic review identified nine women with transposed ovarian recurrence with no other metastases of cervical cancer, and no studies have discussed the optimal surveillance of transposed ovaries. Of those (n = 9), four women had died of the disease within 2 years of the second surgery, and the prognosis of transposed ovarian cervical cancer seemed poor. Nevertheless, three women underwent laparoscopic oophorectomies, none of whom experienced recurrence after the second surgery. Few studies have examined the surgical management of transposed ovarian recurrence. The optimal surgical approach for transposed ovarian recurrence of cervical cancer requires further investigation.
在早期宫颈癌中，卵巢转移相对较少，手术时通常会进行卵巢移位。尽管罕见，但对于转移卵巢的复发，其诊断和手术方法具有挑战性。本研究专注于宫颈癌患者转移卵巢复发的诊断和手术处理。一名 45 岁的绝经前妇女，在因 IB1 期宫颈癌接受根治性子宫切除术、双侧输卵管切除术和盆腔淋巴结清扫术后，接受了术后同期放化疗。在初始手术中，将卵巢移位到结肠旁沟，未观察到术后并发症。使用正电子发射断层扫描-计算机断层扫描诊断卵巢复发，并进行了腹腔镜双侧卵巢切除术。系统评价确定了 9 名患有转移卵巢复发且无宫颈癌其他转移的妇女，且没有研究讨论过转移卵巢的最佳监测方法。在这些患者中（n=9），有 4 名女性在第二次手术后 2 年内死于疾病，转移卵巢宫颈癌的预后似乎较差。尽管如此，有 3 名女性接受了腹腔镜卵巢切除术，她们在第二次手术后均未复发。很少有研究探讨转移卵巢复发的手术处理。需要进一步研究来确定宫颈癌转移卵巢复发的最佳手术方法。
