Will ovarian transposition become the forceps of gynecologic oncology? A survey of the Society of Gynecologic Oncology members (506)

Abstract

Objectives: To determine practice patterns of ovarian transposition (OT) and understand providers’ perceptions of the risks and benefits of the procedure. Methods: Survey links were emailed to all members of the Society of Gynecologic Oncology (SGO). REDcap was used to collect anonymous responses, including demographics, practice patterns, and beliefs regarding OT. Completed survey data were summarized using descriptive statistics; demographics of respondents who did or did not perform OT were compared. Results: The survey was sent to all 1400 physician members of SGO. We received 323 (23%) responses, of which 246 (76%) were completed. Eighty-three (34%) respondents did not perform OT. Of those who performed OT (n=163), 107 (66%) performed 1-2 procedures per year. Respondents who performed OT were statistically older and more likely to be male, married, and had children (p <0.01 for all) (Table 1). Participants who had fewer years in practice or who practiced in an academic setting were less likely to perform OT, whereas respondents in private practice were more likely to perform OT (p <0.03). Practice in New England or the Mid-Atlantic was associated with less OT (p=0.03). Respondent’s ethnicity, patient population, or affiliation with a fertility clinic were not associated with OT practice. For respondents who performed OT, the median, upper age limit for patients undergoing OT was 45 years (range: 35-60 years). Respondents who performed OT used the anterior superior iliac spine (38%), followed by L4-L5 (29%) as a landmark for transposed ovaries. They indicated ovarian failure followed by pain, and cyst formation, as the most common complications. When ranked, the most common indication for OT was the retention of hormonal function, followed by fertility preservation and patient preference. Of all respondents, 36% of patients were rarely or never able to achieve their fertility goals after OT, and 25% felt that OT had, at best, a low likelihood of maintaining hormonal function. Conclusions: Practice patterns of OT vary by demographic factors. There is a need for more conclusive evidence regarding the benefits and risks of the procedure in order to standardize recommendations and determine best practices. Objectives: To determine practice patterns of ovarian transposition (OT) and understand providers’ perceptions of the risks and benefits of the procedure. Methods: Survey links were emailed to all members of the Society of Gynecologic Oncology (SGO). REDcap was used to collect anonymous responses, including demographics, practice patterns, and beliefs regarding OT. Completed survey data were summarized using descriptive statistics; demographics of respondents who did or did not perform OT were compared. Results: The survey was sent to all 1400 physician members of SGO. We received 323 (23%) responses, of which 246 (76%) were completed. Eighty-three (34%) respondents did not perform OT. Of those who performed OT (n=163), 107 (66%) performed 1-2 procedures per year. Respondents who performed OT were statistically older and more likely to be male, married, and had children (p <0.01 for all) (Table 1). Participants who had fewer years in practice or who practiced in an academic setting were less likely to perform OT, whereas respondents in private practice were more likely to perform OT (p <0.03). Practice in New England or the Mid-Atlantic was associated with less OT (p=0.03). Respondent’s ethnicity, patient population, or affiliation with a fertility clinic were not associated with OT practice. For respondents who performed OT, the median, upper age limit for patients undergoing OT was 45 years (range: 35-60 years). Respondents who performed OT used the anterior superior iliac spine (38%), followed by L4-L5 (29%) as a landmark for transposed ovaries. They indicated ovarian failure followed by pain, and cyst formation, as the most common complications. When ranked, the most common indication for OT was the retention of hormonal function, followed by fertility preservation and patient preference. Of all respondents, 36% of patients were rarely or never able to achieve their fertility goals after OT, and 25% felt that OT had, at best, a low likelihood of maintaining hormonal function. Conclusions: Practice patterns of OT vary by demographic factors. There is a need for more conclusive evidence regarding the benefits and risks of the procedure in order to standardize recommendations and determine best practices.