Ovarian preservation among women with early stage cervical cancer. A retrospective evaluation of the incidence of ovarian metastasis.

e17504 Background: Cervical is the second most common cancer affecting Filipino women with the incidence rising among young women. This review looked into the incidence of ovarian metastasis among patients with early stage cervical cancer managed with radical hysterectomy. It also evaluated how many of these women needed to receive adjuvant radiation post-surgery. Methods: This was a 10 –year review of all histopathologic reports of patients with cervical cancer who were primarily managed with radical hysterectomy. Results: A total of 224 patients underwent radical hysterectomy, 12 patients had previous neoadjuvant chemotherapy hence excluded from the study. A total of 212 patients were included in the analysis. Majority had a final histopathologic diagnosis of squamous cell carcinoma and adenocarcinoma at 68% and 29%, respectively. About 3 % comprised the poor histologic types. The reported rates of metastasis to the parametria, corpus, fallopian tubes and nodes were 1.4%, 7.1%, 0.5%, and 10%, respectively. This study showed zero ovarian metastasis in all histologic types. Despite no reported ovarian metastasis in these group of patients, 75% of them required adjuvant therapy after primary surgery. Conclusions: This review revealed that the incidence of local metastasis in early stage cervical cancer is relatively low. However, if present, tumor size is consistently associated with local metastasis. Ovarian metastasis is nil among these group of patients. Ovarian preservation may be a practical option for young patients with early stage cervical cancer to prevent surgical menopause, with a consideration of transposition of the ovaries for patients who will receive adjuvant radiation. Premature ovarian failure associated with adjuvant radiation needs to be considered. Proper counseling and informed consent should be obtained in the treatment planning. The limitation of this report is of its retrospective design; henceforth a more extensive sectioning of the ovary is recommended so as not to miss occult metastasis. A prospective study would be necessary to validate the results of these retrospective reports.