Searching for metastases in ovarian tissue before autotransplantation A tailor made approach

To exclude minimal residual disease in remaining ovarian tissue after harvesting the ovarian cortex for cryopreservation, a tailor-made approach is recommended.

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Authors

Ellen J. Hoekman, M.D., Vincent T.H.B.M. Smit, M.D., Ph.D., Timothy P. Fleming, M.D., Ph.D., Leonie A. Louwe, M.D., Gert Jan Fleuren, M.D., Ph.D., Carina G.J.M. Hilders, M.D., Ph.D.

Volume 103, Issue 2, Pages 469-477

Abstract

Objective:

To exclude minimal residual disease in remaining ovarian tissue after harvesting the ovarian cortex for cryopreservation, by means of a tailor-made approach.

Design:

Retrospective case series.

Setting:

Hospital laboratory.

Patient(s):

We evaluated the ovarian and tubal tissue from 47 cancer patients (breast cancer, [non-]Hodgkin lymphoma; osteo-, Ewing, myxoid lipo-, and oropharyngeal synovial sarcoma; cervical, rectal, and esophageal cancer), who had stored ovarian tissue for fertility preservation.

Intervention(s):

Immunohistochemistry (IHC) with tumor-related antibodies and genetic mutation analysis were performed to detect micrometastases by multiple sectioning at three levels of the paraffin-embedded formalin-fixed material. Molecular assays were performed with the use of tissue between these three levels of sectioning.

Main Outcome Measure(s):

Detection of micrometastases in ovaries.

Result(s):

We analyzed 847 ovarian slides to detect isolated tumor cells (ITCs) or micrometastases by IHC. In only one case (1/47) were ITCs detected in the fallopian tube. That patient had an intra-abdominal metastatic esophageal carcinoma. Additional DNA analyses of breast and rectal cancer, Ewing sarcoma, and human papilloma virus in cervical patients did not show evidence of micrometastases in the ovarian tissue.

Conclusion(s):

The tailor-made approach consisted of patient-specific tumor markers which were used to search for ovarian micrometastases. We found evidence of metastatic disease within the fallopian tube of a patient with intraperitoneal metastatic esophageal adenocarcinoma.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)02315-2/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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