Risk of ovarian recurrence after ovarian conservation in early-stage cervical cancer treated with radical surgery: A propensity match analysis

Bizzarri, Nicolò; Anchora, Luigi Pedone; Kucukmetin, Ali; Ratnavelu, Nithya; Korompelis, Porfyrios; Fedele, Camilla; Bruno, Matteo; Fiore, Giacomo Lorenzo Maria Di; Fagotti, Anna; Fanfani, Francesco; Scambia, Giovanni

doi:10.1016/j.ejso.2021.04.009

Cited by 6 publications

(10 citation statements)

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“…According to the National Comprehensive Cancer Network (NCCN) guideline, ovarian transposition can be considered before pelvic radiotherapy in select young patients (<45 years old with early-stage disease) [ 42 ]. It is essential to balance the oncological risk of ovarian metastasis and the benefit of maintaining ovarian hormones [ 14 ]. Therefore, appropriate case selection for ovarian preservation needs to be discussed.…”

Section: Discussionmentioning

confidence: 99%

“…The study included 419 women with clinical FIGO 2009 stage IA1-IB1/IIA1 cervical cancer, with 264 and 155 women undergoing ovarian conservation and oophorectomy, respectively. In this study, a survival analysis after propensity-score matching was performed, and a significantly higher 5-year disease-free survival was observed in the ovarian conservation group than in the oophorectomy group (90.6% versus 82.2%, P = 0.028), whereas overall survival was similar between the groups (94.3% versus 90.8%, P = 0.157) [ 14 ]. Regarding the menopausal disorders, 28 women (20.6%) in the ovarian conservation group versus 116 (60.4%) in the oophorectomy group complained of menopausal symptoms ( P < 0.01) [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the study [ 14 ], the authors considered the following three merits of ovarian conservation if the oncologic risk was acceptable: (i) menopausal symptoms were less frequent in the ovarian conservation group than in the hormone replacement therapy with oophorectomy group; (ii) estrogen and progesterone have potential protective role in cervical carcinoma; and (iii) lower rates of metabolic syndrome, osteoporosis, cardiovascular events, and neurologic disorders.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of ovarian metastasis in women with early cervical cancer (stages I-II) has been widely reported [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. The rate of ovarian metastasis in SCC is low in early-stage cervical cancer (0–1.3%); thus, ovarian preservation in the case of SCC histology is feasible.…”

Section: Discussionmentioning

confidence: 99%

“…Ovarian preservation and transposition are considered feasible in women who opt for them, considering the low rate of ovarian metastasis from cervical cancer with squamous cell carcinoma (SCC) [ 1 , 5 ]. Conversely, ovarian preservation in cervical adenocarcinoma patients is more controversial as several studies have reported a high rate of ovarian metastasis with wide range (1.0–12.9%) [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. A systematic review reported that the rate of ovarian metastasis was approximately 2% in women with stage IB cervical adenocarcinoma [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Surgical Management for Transposed Ovarian Recurrence of Cervical Cancer: A Systematic Review with Our Experience

et al. 2022

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In early-stage cervical cancer, ovarian metastasis is relatively rare, and ovarian transposition is often performed during surgery. Although rare, the diagnosis and surgical approach for recurrence at transposed ovaries are challenging. This study focused on the diagnosis and surgical management of transposed ovarian recurrence in cervical cancer patients. A 45-year-old premenopausal woman underwent radical hysterectomy, bilateral salpingectomy, and pelvic lymphadenectomy following postoperative concurrent chemoradiotherapy for stage IB1 cervical cancer. During the initial surgery, the ovary was transposed to the paracolic gutter, and no postoperative complications were observed. Ovarian recurrence was diagnosed using positron emission tomography–computed tomography, and a laparoscopic bilateral oophorectomy was performed. A systematic review identified nine women with transposed ovarian recurrence with no other metastases of cervical cancer, and no studies have discussed the optimal surveillance of transposed ovaries. Of those (n = 9), four women had died of the disease within 2 years of the second surgery, and the prognosis of transposed ovarian cervical cancer seemed poor. Nevertheless, three women underwent laparoscopic oophorectomies, none of whom experienced recurrence after the second surgery. Few studies have examined the surgical management of transposed ovarian recurrence. The optimal surgical approach for transposed ovarian recurrence of cervical cancer requires further investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%