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Ovarian function after radical hysterectomy with ovarian preservation for cervical cancer
1Department of Obstetrics and Gynecology, Niigata University School of Medicine, 1-757 Asahimachi-dori, Niigata 951-8510, Japan. keisui28@med.niigata-u.ac.jp
Objective:
To investigate the function of preserved ovaries following radical hysterectomy in premenopausal women with cervical carcinoma and to attempt to identify clinical factors influencing ovarian function.
Study Design:
Between 1991 and 1998, 33 premenopausal patients with International Federation of Gynecology and Obstetrics stage IB and II cervical cancer underwent radical hysterectomy with ovarian preservation, including lateral ovarian transposition in 20 patients. In 12 cases of squamous cell carcinoma with deep stromal invasion or a suspicious, positive node, neoadjuvant chemotherapy was performed. Postoperative whole pelvic radiotherapy was administered to 11 patients. Ovarian function was evaluated by serum FSH level during the follow-up period, 12 months to 9 years.
Results:
Fifteen of 33 patients became climacteric after treatment. Ten of 12 patients over 40 years old became climacteric, as did 5 of 21 under 39 (P = .0013). Using multiple regression analysis, a significant correlation between ovarian dysfunction and age (under 40) was observed (P = .0286). No ovarian recurrence or symptomatic ovarian cyst was observed in preserved ovaries during the study period.
Conclusion:
Ovarian preservation is safe in patients under 40 years old undergoing radical hysterectomy even if they received additional treatment, such as neoadjuvant chemotherapy or postoperative radiotherapy with ovarian transposition.