Association between the location of transposed ovary and ovarian function in patients with uterine cervical cancer treated with (postoperative or primary) pelvic radiotherapy
Association between the location of transposed ovary and ovarian function in patients with uterine cervical cancer treated with (postoperative or primary) pelvic radiotherapy
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DOI：
10.1016/j.fertnstert.2012.02.052
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发表时间：
2012-06-01
影响因子：
6.7
通讯作者：
Park, Sang-Yoon
中科院分区：
文献类型：
--
作者：
Hwang, Jong Ha;Yoo, Heon Jong;Park, Sang-Yoon
目的：评价卵巢移位术在保留卵巢功能方面的有效性，与接受手术伴或不伴盆腔放疗的患者的卵巢移位位置有关。设计：回顾性。设置：子宫癌中心。患者：2002年11月至2010年11月期间共53例接受卵巢移位术的宫颈癌患者。干预：结果：53例患者行卵巢侧位移位术，术后随访1 ~ 12个月，观察卵巢功能的恢复情况，并根据患者的临床症状和血清FSH水平进行评估。根据受试者工作特征曲线分析，髂嵴上方1.5 cm以上位置的最佳截止值与治疗后卵巢功能的保留显著相关（受试者工作特征曲线下面积：0.757，95%置信区间[CI]：0.572-0.943）。在单因素分析中，卵巢移位位置高于髂嵴1.5 cm是卵巢功能完好的唯一独立因素（比值比9.91，95% CI：1.75-56.3）。多因素分析证实，卵巢移位的位置（OR 11.72，95% CI 1.64-83.39）是影响卵巢功能完好的最重要因素。结论：宫颈癌患者行盆腔放疗后，卵巢移位的位置宜高于髂嵴以上1.5cm，以避免卵巢功能衰竭。（Fertil Steril（R）2012;97：1387-93. (C)美国生殖医学会（American Society for Reproductive Medicine）
Objective: To evaluate the effectiveness of ovarian transposition procedures in preserving ovarian function in relation to the location of the transposed ovaries in patients who underwent surgery with or without pelvic radiotherapy.Design: Retrospective.Setting: Uterine cancer center.Patient(s): A total of 53 patients with cervical cancer who underwent ovarian transposition between November 2002 and November 2010.Intervention(s): Ovarian transposition to the paracolic gutters with or without radical hysterectomy and lymph node dissection.Main Outcome Measure(s): Preservation of ovarian function, which was assessed by patient's symptoms and serum FSH level.Result(s): Lateral ovarian transposition was performed in 53 patients. Based on receiver operator characteristic curve analysis, optimum cutoff value of location more than 1.5 cm above the iliac crest was significantly associated with preservation of ovarian function after treatment (area under receiver operator characteristic curve: 0.757, 95% confidence interval [CI]: 0.572-0.943). In univariate analysis, higher location of transposed ovary more than 1.5 cm from the iliac crest was the only independent factor for intact ovarian function (odds ratio 9.91, 95% CI: 1.75-56.3). Multivariate analysis confirmed that the location of transposed ovary (odds ratio 11.72, 95% CI 1.64-83.39) was the most important factor for intact ovarian function.Conclusion(s): Location of transposed ovary higher than 1.5 cm above the iliac crest is recommended to avoid ovarian failure after lateral ovarian transposition after primary or adjuvant pelvic radiotherapy in cervical cancer. (Fertil Steril (R) 2012;97:1387-93. (C) 2012 by American Society for Reproductive Medicine.)