Abstract

To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%) , OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS) . These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. P ≤ 0.05 was considered to be statistically significant. The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.

Highlights

  • An ovarian-sparing radical hysterectomy has become a standard procedure for the treatment of early stage cervical cancer in young women in order to preserve ovarian hormonal function (Morice et al, 2000)

  • While the 5-year disease-free survival (DFS) rate was not statistically significant between the ovarian transposition (OT) and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year overall survival (OS) rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05)

  • Ovarian metastasis was not detected in any of the patients treated with oophorectomy

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Summary

Introduction

An ovarian-sparing radical hysterectomy has become a standard procedure for the treatment of early stage cervical cancer in young women in order to preserve ovarian hormonal function (Morice et al, 2000) For this procedure, the ovaries, normal to inspection and palpation, are transposed and fixed outside of the pelvis to the paracolic space higher than 1.5 cm above the iliac crest in order to be outside of an applied radiation field (Hwang et al, 2012). The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS) These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory

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