A 30-year-old woman with Stage IB1 cervical cancer is undergoing radical hysterectomy. Regarding ovarian preservation, which statement is correct?
- A Ovaries may be preserved in squamous carcinoma, but removal is advised in adenocarcinoma because of higher rates of ovarian metastasis ✓
- B Ovaries should always be removed because ovarian metastasis exceeds 10 percent in all histologies
- C Ovaries may be preserved safely regardless of histological subtype
- D Ovarian preservation is permissible only after completion of adjuvant radiotherapy
Correct answer: A. Ovaries may be preserved in squamous carcinoma, but removal is advised in adenocarcinoma because of higher rates of ovarian metastasis
Explanation
Ovarian metastasis occurs in well under 2 percent of early-stage squamous carcinomas, so ovaries can be conserved, ideally with transposition out of the radiation field, in young women with squamous tumours. Adenocarcinoma carries a substantially higher rate of ovarian spread, approaching 10 percent in some series, so oophorectomy is recommended. Preservation before radiotherapy with transposition is the correct sequence, making option D illogical since irradiation destroys transposed tissue only if it remains in field.
Reference: Berek and Novak's Gynecology, 16th ed.
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