Prophylactic salpingectomy and ovarian cancer: An evidence-based analysis

Abstract

Introduction:One of the ovarian carcinogenesis theories was the presence of premalignant cells in the epithelium of the fallopian tube. Therefore, the prophylactic salpingectomy during benign gynecological surgery is now expected as the attempt to reduce the ovarian cancer incidence. We studied the effect of prophylactic bilateral salpingectomy (PBS) in reducing the ovarian cancer incidence.Methods:This evidence-based report resulted from critical appraisal of 5 articles. It is aimed to answer our clinical question, can bilateral prophylactic salpingectomy reduce the incidence of ovarian cancer among women underwent hysterectomy for benign condition or permanent contraception surgery? The search was conducted on the Cochrane Library®, PubMed®, and Embase® using keywords of “prophylactic salpingectomy,” and “ovarian cancer incidence.” Reference lists of relevant articles were searched for other possibly relevant articles.Results:Five studies were included in our appraisal. The incidence of ovarian cancer among women underwent prophylactic salpingectomy is lower compared to women who were not underwent any intervention (2.2% to 13% and 4.75% to 24.4%). The salpingectomy may reduce 29.2% to 64% of ovarian cancer incidence. No significant effect of PBS to ovarian function, quality of life, sexuality, surgery duration, and its cost-effective profile were also found throughout our literature study.Conclusion:PBS is suggested to be performed for women during benign gynecological surgery as a primary preventive strategy of ovarian cancer. PBS is a cost-effective procedure, risk-reducing for ovarian cancer and has no significant effect to the ovarian function.

ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma

“…[252][253][254] Salpingectomy during hysterectomy is recommended to decrease the risk of high-grade serous ovarian carcinoma. 255 Ovarian preservation is not recommended in patients with cancer family history involving ovarian cancer risk (eg, BRCA mutation, Lynch syndrome, etc), but oocyte cryopreservation might be considered. 256 Recommendations ► Ovarian preservation can be considered in pre-menopausal patients aged <45 years with low-grade endometrioid endometrial carcinoma with myometrial invasion <50% and no obvious ovarian or other extra-uterine disease (IV, A).…”

Congenital Dysfibrinogenemia Presented with Massive Hematomas Formed after Hysterectomy

“…Screening tests before the operation showed no abnormalities, including PT and APTT (Table 1) and liver functions. She wished to receive an early hysterectomy, and then she underwent an abdominal hysterectomy and bilateral salpingectomy (Figure 1(B)) for reducing the future ovarian cancer incidence [12], after administering GnRH antagonist for one month. The operation for 121 minutes was performed as usual, and the blood loss was 100 g (ml).…”

Patients’ perceptions toward and the driving factors of decision-making for opportunistic bilateral salpingectomy at the time of cesarean section

“…It has been hypothesized previously that the fallopian tubes are very likely to be the origin of high-grade serous cancers ( 6 ) , and thus, prophylactic or opportunistic salpingectomy at the time for hysterectomy and other benign procedures may be beneficial. The incidence of ovarian cancer among women who had undergone prophylactic salpingectomy along with hysterectomy for benign condition was found to be reduced to 30-64% ( 7 ) . In addition, a large body of evidence revealed that prophylactic bilateral salpingectomy had no significant negative effect on the ovarian function, quality of life, sexuality, surgery duration, and cost-effectivity ( 7 ) .…”

“…The incidence of ovarian cancer among women who had undergone prophylactic salpingectomy along with hysterectomy for benign condition was found to be reduced to 30-64% ( 7 ) . In addition, a large body of evidence revealed that prophylactic bilateral salpingectomy had no significant negative effect on the ovarian function, quality of life, sexuality, surgery duration, and cost-effectivity ( 7 ) .…”