Introduction/Background Preservation of ovarian function in cancer patients is relevant for fertility, long-term bone, cardiovascular and cognitive health. In this study, we aim to study the success rate of ovarian transposition above the pelvic rim to limit the radiation dose to the ovaries. Furthermore, this study compares the influence of performing this treatment robot assisted versus laparoscopy or laparotomy

Methodology The records of patients who underwent an ovarian transposition before pelvic radiation therapy between 2001 and 2022 were reviewed retrospectively. The ovary was transposed at least 3 cm above the pelvic rim in the paracolic gutter and marked with a clip. The radiation dose was aimed to be limited to Dmax <5Gy. Menopausal symptoms and/or follicle-stimulating hormone (FSH) > 30 IU/L were used as endpoints.

Results A total of 50 women were included with a median age of 31 years old (range 10–42 years old). The majority was treated for cervical cancer (n=39) or rectal cancer (n=4). Unilateral transposition was most frequently performed (n=44) compared to bilateral transposition (n=6). The indications for surgery besides the ovarian transposition were most frequently a Wertheim-Meigs or a lymphadenectomy.

A robot assisted procedure was performed in 24 cases compared to laparotomy in 7 and laparoscopy in 13.

After a median follow-up of 4 years (range 1–20 years), 24 (48%) patients remained premenopausal. Of the 26 patients with postmenopausal symptoms and/or blood results, 23 had been treated for cervical cancer, one for rectal carcinoma and two for cancer of the vagina.

Thirty-two percent of patients younger than 30 years old were menopausal after treatment compared to 68% of patients older than 30 years old.

Conclusion Positioning of the ovaries outside the radiation field prior to radiotherapy to be effective in about half of patients. Given the effectiveness of the procedure, this should be considered before pelvic radiotherapy in premenopausal women.

Disclosures Nothing to disclose.