J Gynecol Oncol.  2013 Apr;24(2):204-207. 10.3802/jgo.2013.24.2.204.

Maintenance of ovarian function in end-of-life cervical cancer patient following primary surgico-radiotherapy and ovarian transposition

• Sicam RV
• Huang KG
• Chang YC
• Lee CL

• KMID: 2288552
• DOI: http://doi.org/10.3802/jgo.2013.24.2.204

Abstract

A 35-year-old woman underwent laparoscopic radical hysterectomy, pelvic lymphadenectomy and ovarian transposition for stage IB2 cervical adenocarcinoma. She received adjuvant concurrent chemoradiation for poor pathologic risk factors but had tumor recurrence 20 months after the surgery. Transposed ovaries were uninvolved in the recurrence and progression. Salvage chemotherapy and radiotherapy were given. Despite systemic chemotherapy and repeat pelvic radiotherapy, the patient was able to maintain ovarian function. Ovarian transposition in cervical cancer is an easily performed procedure that does not alter the prognosis of the disease in some cases. Present recommendations for its use should be reevaluated so that more premenopausal cancer patients may benefit from this underutilized procedure.

Keyword

Laparoscopy; Ovarian transposition; Poor prognostic factors; Quality of life; Tumor recurrence; Uterine cervical cancer

MeSH Terms

Adenocarcinoma
Female
Humans
Hysterectomy
Laparoscopy
Lymph Node Excision
Ovary
Prognosis
Quality of Life
Recurrence
Risk Factors
Uterine Cervical Neoplasms

Figure

• 

  Fig. 1 The ovaries are transposed to the antero-lateral abdominal wall, underneath the upper trocars on each side. Pelvic radiation field is below the dotted line. A, Lee-Huang point, the location of the main trocar and is midway between the umbilicus and xiphoid process; B, lower accessory trocars; O, ovaries; U, umbilicus; X, xiphoid process.

• 

  Fig. 2 Imaging survey seven months after recurrence, two years and four months after ovarian transposition. Computed tomography (CT) scan picture of right (A) and left (B) ovaries marked by metallic clips fixed at the anterior abdominal wall 3 centimeter above the umbilicus. Ultrasound pictures of right (C) and left (D) adnexae showing normal size ovaries.

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