Long-term outcomes of hysterectomy with bilateral salpingo-oophorectomy: a systematic review and meta-analysis

Hassan, Hend; Allen, Isaac; Sofianopoulou, Eleni; Walburga, Yvonne; Turnbull, Clare; Eccles, Diana; Tischkowitz, Marc; Pharoah, Paul D.P.; Antoniou, Antonis C.

doi:10.1016/j.ajog.2023.06.043

Cited by 9 publications

(5 citation statements)

References 58 publications

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“…Complete hysterectomy is the norm, with bilateral oophorectomy performed in up to 80% of cases [27]. However, removal of the ovaries predisposes women to multiple co-morbidities including increased risk of cardiovascular disease, dementia and certain cancers amongst others [27][28][29]; current recommendations, therefore, suggest a cautious approach to ovarian removal [30]. In the case of benign disease, which outnumbers malignant diagnoses by ~9:1 [30,31], there is a clear need to differentiate pre-surgically to enhance patient outcomes-particularly in the case of pre-menopausal patients, where fertility preservation may be an important consideration and requires specialist input [32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

A Novel Predictive Multi-Marker Test for the Pre-Surgical Identification of Ovarian Cancer

Stephens,

Hobbs,

Kang

et al. 2023

Cancers

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Ovarian cancer remains the most lethal of gynecological malignancies, with the 5-year survival below 50%. Currently there is no simple and effective pre-surgical diagnosis or triage for patients with malignancy, particularly those with early-stage or low-volume tumors. Recently we discovered that CXCL10 can be processed to an inactive form in ovarian cancers and that its measurement has diagnostic significance. In this study we evaluated the addition of processed CXCL10 to a biomarker panel for the discrimination of benign from malignant disease. Multiple biomarkers were measured in retrospectively collected plasma samples (n = 334) from patients diagnosed with benign or malignant disease, and a classifier model was developed using CA125, HE4, Il6 and CXCL10 (active and total). The model provided 95% sensitivity/95% specificity for discrimination of benign from malignant disease. Positive predictive performance exceeded that of “gold standard” scoring systems including CA125, RMI and ROMA% and was independent of menopausal status. In addition, 80% of stage I-II cancers in the cohort were correctly identified using the multi-marker scoring system. Our data suggest the multi-marker panel and associated scoring algorithm provides a useful measurement to assist in pre-surgical diagnosis and triage of patients with suspected ovarian cancer.

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Section: Discussionmentioning

confidence: 99%

A Novel Predictive Multi-Marker Test for the Pre-Surgical Identification of Ovarian Cancer

Stephens,

Hobbs,

Kang

et al. 2023

Cancers

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“… 5 , 6 A further strength is that we were able to account for prophylactic and curative surgeries such as partial or full resections at the contralateral breast, ovary, and endometrium in our censoring process when estimating SPC risks at these sites, minimising confounding biases in our risk estimates. 16 …”

Section: Discussionmentioning

confidence: 99%

Risks of second primary cancers among 584,965 female and male breast cancer survivors in England: a 25-year retrospective cohort study

Allen,

Hassan,

Joko-Fru

et al. 2024

The Lancet Regional Health - Europe

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“…Due to multiple co-morbidities associated with oophorectomies (e.g., increased risk of heart disease, osteoporosis and some cancers) [35][36][37], current ACOG guidelines suggest a conservative surgical approach for the management of adnexal mass and the use of laparoscopic techniques where possible [4]. Of particular interest therefore was the re-classification of "false positive" patients with elevated CA125 who were subsequently diagnosed with benign disease.…”

Section: Discussionmentioning

confidence: 99%

ReClassification of Patients with Ambiguous CA125 for Optimised Pre-Surgical Triage

Stephens,

Hobbs,

Kang

et al. 2024

Diagnostics

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Pre-surgical clinical assessment of an adnexal mass is a complex process, and ideally requires accurate and rapid identification of disease status. Gold standard biomarker CA125 is extensively used off-label for this purpose; however its performance is typically inadequate, particularly for the detection of early stage disease and discrimination between benign versus malignant status. We recently described a multi-marker panel (MMP) and associated risk index for the differentiation of benign from malignant ovarian disease. In this study we applied a net reclassification approach to assess the use of MMP index to rescue those cases where low CA125 incorrectly excludes cancer diagnoses, or where benign disease is incorrectly assessed as “high risk” due to elevated CA125. Reclassification of such patients is of significant value to assist in the timely and accurate referral for patients where CA125 titer is uninformative.

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Long-term outcomes of hysterectomy with bilateral salpingo-oophorectomy: a systematic review and meta-analysis

Cited by 9 publications

References 58 publications

A Novel Predictive Multi-Marker Test for the Pre-Surgical Identification of Ovarian Cancer

A Novel Predictive Multi-Marker Test for the Pre-Surgical Identification of Ovarian Cancer

Risks of second primary cancers among 584,965 female and male breast cancer survivors in England: a 25-year retrospective cohort study

ReClassification of Patients with Ambiguous CA125 for Optimised Pre-Surgical Triage

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