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Correlation Between Location of Transposed Ovary and Function in Cervical Cancer Patients Who Underwent Radical Hysterectomy
  1. Aera Yoon, MD*,
  2. Yoo-Young Lee, MD, PhD*,
  3. Won Park, MD, PhD,
  4. Seung Jae Huh, MD, PhD,
  5. Chel Hun Choi, MD, PhD*,
  6. Tae-Joong Kim, MD*,
  7. Jeong-Won Lee, MD, PhD*,
  8. Byoung-Gie Kim, MD, PhD* and
  9. Duk-Soo Bae, MD, PhD*
  1. *Departments of Obstetrics and Gynecology, and
  2. Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
  1. Address correspondence and reprint requests to Duk-Soo Bae, MD, PhD, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135–710, South Korea. E-mail: yyl.lee{at}samsung.com.

Abstract

Objective The study investigated the association between the location of transposed ovaries and posttreatment ovarian function in patients with early cervical cancer (IB1-IIA) who underwent radical hysterectomy and ovarian transposition with or without adjuvant therapies.

Methods Retrospective medical records were reviewed to enroll the patients with early cervical cancer who underwent ovarian transposition during radical hysterectomy at Samsung Medical Center between July 1995 and July 2012. Serum follicle-stimulating hormone (FSH) level was used as a surrogate marker for ovarian function.

Results Twenty-one patients were enrolled. The median age and body mass index (BMI) were 31 years (range, 24–39 years) and 21.3 kg/m2 (range, 17.7–31.2 kg/m2), respectively. The median serum FSH level after treatment was 7.9 mIU/mL (range, 2.4–143.4 mIU/mL). The median distance from the iliac crest to transposed ovaries on erect plain abdominal x-ray was 0.5 cm (range, −2.7 to 5.2 cm). In multivariate analysis, posttreatment serum FSH levels were significantly associated with the location of transposed ovaries (β = −8.1, P = 0.032), concurrent chemoradiation (CCRT) as an adjuvant therapy (β = 71.08, P = 0.006), and BMI before treatment (underweight: β = −59.93, P = 0.05; overweight: β = −40.62, P = 0.041).

Conclusions Location of transposed ovaries, adjuvant CCRT, and BMI before treatment may be associated with ovarian function after treatment. We suggest that ovaries should be transposed as highly as possible during radical hysterectomy to preserve ovarian function in young patients with early cervical cancer who might be a candidate for adjuvant CCRT and who have low BMI before treatment.

  • Ovarian transposition
  • Cervical cancer
  • Concurrent chemoradiotherapy
  • FSH
  • Ovarian function

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Footnotes

  • The authors declare no conflicts of interest.