%0 Journal Article
%T The Need for Laparoscopic Ovarian Transposition in Young Patients with Cervical Cancer Undergoing Radiotherapy
%A Hariyono Winarto
%A Eva Febia
%A Gatot Purwoto
%A Laila Nuranna
%J International Journal of Reproductive Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/173568
%X Maintaining the quality of life by preserving ovarian function in premenopausal patients with cervical cancer undergoing radiation is crucial. This can be accomplished with a simple and safe laparoscopic ovarian transposition procedure. This procedure aims to move the ovary out of the irradiation field, protecting it from direct radiation and irreversible damage and preserving its function. However, this procedure is often forgotten and seldom offered to patients. This review aims to lay stress on and reconsider the importance of laparoscopic ovarian transposition as a simple, safe, and extremely useful procedure. The biological effects of radiation are described briefly and several studies are evaluated, which reveal that this procedure has more benefits than risks. 1. Introduction Cervical cancer is one of the commonest malignancies in Indonesian women. The annual incidence is 9.25 per 100000 population. Due to advances in screening and treatment, patients with cervical cancer are being diagnosed at a younger age and earlier stage of the disease. Approximately half the patients are premenopausal and under 45 years old. Radiotherapy, which constitutes almost 80% of all cancer treatment modalities, causes irreversible ovarian damage and leads to premature menopause, which affects the quality of life. Young women with cervical cancer who are irradiated often have to suffer the long-term consequences of ovarian failure. In addition to curing those patients, maintaining their quality of life is important for a gynecologist. Improved quality of life is significantly associated with improved survival in patients with cervical cancer [1¨C8]. A simple procedure for preventing radiotherapy-induced ovarian damage is laparoscopic ovarian transposition. This procedure has not been implemented widely even though many studies have revealed its benefits and efficacy. This review assesses the use of ovarian transposition as an effective method for preserving ovarian function in young patients with cervical cancer undergoing radiotherapy and compares the benefits of ovarian transposition performed via laparoscopy and via laparotomy [9¨C13]. 2. The Biological Effect of Radiotherapy and the Fate of Retained versus Transposed Ovaries Radiotherapy aims to deliver a precisely measured dose of radiation to a defined tumor volume with minimum possible damage to the surrounding normal tissue. Ionizing radiotherapy interacts with DNA. The initial DNA damage leads to a cascade of biologic events that cause lethality when the cells attempt to divide (mitotic death) or programmed
%U http://www.hindawi.com/journals/ijrmed/2013/173568/