Skip to main content

Table 1 Characteristics of studies

From: Outcomes of ovarian transposition in gynaecological cancers; a systematic review and meta-analysis

First author and year of publication Study design Population Intervention Outcome(s) Follow up (median, range)
Hodel 1982[7] Retrospective Women with vaginal (n = 2) and cervical (n = 7) cancers Open-lateral OT in patients undergoing radical surgery followed by pelvic irradiation (n = 9) Ovarian function by clinical symptoms and FSH levels NR
Husseinzadeh 1984[20] Prospective Women with cervical (n = 39) and vaginal (n = 1) cancers Open–lateral OT in patients with RH + lymphadenectomy (n = 22), primary radiotherapy alone (n = 14) and radiotherapy following surgery (n = 4) Ovarian function by FSH, LH levels, 15/22 from surgery only group were included for which FSH levels were available NR
Ploch 1988[21] Prospective Women with cervical cancer (n = 22) RH with OT of one or both ovaries outside the pelvis (n = 5) followed by adjuvant radiotherapy (n = 17), BR only (n = 5) and BR + teletherapy (n = 12) Ovarian function by FSH, LH, E2 and progesterone levels, additional analysis of location of transposed ovaries 13 (2–23)
Owens 1989[22] Retrospective All but 3 patients had early stage cervical cancer (n = 14) All but one had bilateral open OT to the paracolic gutters (n = 14) in addition to RH, post-operative radiotherapy (n = 8) Oestrogen deficiency symptoms, metastatic disease or required reoperation secondary to new ovarian pathology. 18
Chambers 1990[23] Retrospective Premenopausal women with cervical cancer stage IA and IB (n = 84) Lateral OT in addition to RH (n = 25) compared to non-OT group (n = 59) Symptomatic ovarian cysts and symptoms of menopause by FSH and LH levels 14 (2–23)
Van Beurden 1990[24] Retrospective Women with cervical cancer (n = 44) Open intraperitoneal OT in a lateral and cranial direction (n = 44): In 16/44 women, only one ovary could be preserved and transposed and radiotherapy (n = 6) Menopausal symptoms, measurement of FSH where available (n = 6) 23 (10–36)
Chambers 1991[25] Retrospective Women with stage 1 cervical cancer (n = 38) Open (sc) lateral OT (n = 38) as part of their initial operative procedure and post-operative radiotherapy (n = 14) Ovarian function by FSH/LH, ovarian preservation directly related to estimated scattered dose to ovaries, symptomatic ovarian cysts by USS 35
Anderson 1993[26] Retrospective Premenopausal women with early stage cervical cancer (n = 104) Open-lateral OT (n = 82) , post-operative radiotherapy (n = 24), comparison with non-OT group (n = 22) Retention of ovarian function, symptomatic ovarian cysts and metastases 44
Bidzinski 1993[27] Retrospective Women with stage Ia and Ib carcinoma of the cervix (n = 48) RH with OT (n = 48), EBRT (n = 15) and BR (n = 24) Effect on ovarian function 40 (10–72)
Feeney 1995[28] Retrospective Women with stage I-IIa cervical cancer (n = 132) Lateral OT at the time of RH (n = 132), post-operative radiotherapy (n = 28) Menopausal symptoms, FSH levels and adnexal pathology, Ovarian function is reserved only in 50% of patients with post-operative BR 24
Clough 1996[9] Prospective Women with cervical cancer (n = 17) Laparoscopic unilateral OT (n = 17) post-operative BR (n = 14 ) and EBRT + BR (n = 3) Evaluation of ovarian function by clinical and laboratory criteria, 100% ovarian preservation in patients younger than 40 years old 23 (12–33)
Covens 1996[29] Retrospective Patients with 1B cervical cancer prior to radiation therapy (n = 3) Laparoscopic OT (n = 3) and had intarcavitary radiation desiring preservation of fertility. Menstruating regularly after completion of treatment with serum FSH in the normal premenopausal range. 32
Fujiwara 1997[8] Retrospective Description of a new technique for OT (n = 27), women with cervical cancer only were included (n = 12) Open (sc) OT ovary (benign = 15, cancer = 12) and post-operative EBRT (n = 10) and BR (n = 1) Cyst formation, symptoms of menopause with FSH levels measurement 26 (10–44)
Morice 1998a[30] Retrospective Women with 27 vaginal cancers, 9 ovarian dysgerminomas and 1 pelvic sarcoma Laparoscopic OT Ovarian function, cysts and prognosis for fertility 6
Morice 1998b[31] Prospective Only 14/ 24 were included as they were repeated in other paper published by the same author and 4 non gyanecological malignancies, 12 clear cell vaginal and cervical cancers, 1 vaginal adenocarcinoma, 1 dysgerminoma Laparoscopic OT (n = 14), BR (n = 13) and EBRT (n = 5) Clinical and laboratory follow-up tests of ovarian function and clinical pregnancies. 6
Morice 2000[32] Prospective Women with cervical cancer (n = 107) Laparoscopic bilateral OT to the paracolic gutters with RH and lymphadenectomy only (n = 11), with 60 Gy of vaginal BR along with surgery (n = 59) or surgery, BR and 45 Gy of EBRT (n = 25) Ovarian function: by clinical symptoms, FSH, E2 level, 12 patients were lost to follow up, ovarian cysts: by USS 31 (10–56)
Buekers 2001[33] Retrospective Women with cervical cancer (n = 80) Open OT to one or both ovaries at the time of exploration for RH or staging lymphadenectomy, postoperative irradiation (n = 26) Ovarian function by FSH, report of cyclic signs and menopausal symptoms, analysis of estrogen effect to vaginal epithelium 85 (43–126)
Olejek 2001[34] Retrospective Women with cervical cancer for which follow up was available (n = 44) Open OT, comparison of ovarian preservation between RT and non-RT groups Ovarian function by FSH, LH, E2, PRL, testosterone, ovarian cysts by USS 60
Yamamoto 2001[10] Prospective Women with cervical cancer (n = 56) Regression analysis of risk factors for ovarian metastases Open OT during RH only (n = 30), with pelvic irradiation (n = 26) Ovarian function by basal bosy temperature, FSH, E2 and PG, regression analysis of risk factors for ovarian metastases 12
Nagao 2006[35] Retrospective Comparison between OT (n = 27)and 2 non-OT groups (n = 59) for ovarian preservation Open OT following RH (n = 27) Ovarian function by FSH 65
Pahisa 2008[36] Prospective Women with 1b1 cervical cancer (n = 28) Laparoscopic OT with no RT(n = 16), BR (n = 7) and EBRT + BR (n = 5) Ovarian function by clinical symptoms and FSH and E3; follow up available for 24/28 patients, ovarian cysts by annual surveillance abdominal CT 44
Al-Badawi 2010[37] Retrospective Women with cervical cancer (n = 15) Bilateral laparoscopic OT to the paracolic gutters with uterine preservation followed by pelvic irradiation (n = 15) Ovarian function by clinical symptoms and FSH 33
Han 2011[38] Retrospective Women with cervical cancer (n = 29), comparison with non-OT group OT in cervical cancer patients (n = 29) prior to pelvic irradiation Ovarian function by E2 and FSH, 19/29 patients were included for which hormonal levels were available 17.2
Hwang 2012[39] Retrospective Women with cervical cancer (n = 53), 39/53 patients were included Open (n = 19) and laparoscopic (n = 34) OT to the paracolic gutters with primary chemoradiotherapy only (n = 3), with RH and lymphadenectomy (n = 33) followed by adjuvant RT (n = 23), with lymphadenectomy followed by primary chemoradiotherapy (n = 17) Ovarian function by clinical symptoms and FSH,14/53 patients were lost on follow up or FSH not available 39.8
  1. sc = Subcutaneous.
  2. NR = Not reported.
  3. OT = Ovarian transposition.