Risk of epithelial ovarian cancer Type I and II after hysterectomy, salpingectomy and tubal ligation—A nationwide case‐control study

Abstract

The proposed different origins and pathways to of the dualistic model of epithelial ovarian cancer (EOC) may affect and alter the potential risk reduction related to hysterectomy, salpingectomy and tubal ligation. The aim of our study was to analyze associations between hysterectomy, salpingectomy or tubal ligation and risk reduction of EOC Type I and II. In this nationwide register‐based case‐control study, women diagnosed with EOC, Fallopian tube or primary peritoneal cancer between 2008 and 2014 were included. Cases were classified into Type I and II according to histology and predefined criteria. The exposure variables: hysterectomy, salpingectomy and tubal ligation were identified from national registries. Conditional logistic regression analyses were performed to evaluate associations between Type I and II EOC and the exposure variables. Among 4669 registered cases, 4040 were eligible and assessed for subtyping resulting in 1033 Type I and 3007 Type II. Ten controls were randomly assigned to each case from the register of population. In regression analyses, women with previous salpingectomy had a significantly lower risk of EOC Type II (odds ratio [OR] 0.62; 95% confidence interval [95%CI] 0.45‐0.85) but not Type I (OR 1.16; 95%CI 0.75‐1.78). Hysterectomy was associated with a reduced risk of both EOC Type I (OR 0.71; 95%CI 0.52‐0.99) and Type II (OR 0.81; 95%CI 0.68‐0.96). Similar estimates were obtained for tubal ligation, although without statistical significance. The association between salpingectomy and reduced risk of EOC Type II supports the proposed theory of high‐grade serous cancer originating from the tubal fimbriae.

Perinatology and reproductology: from research to practice

“…Останніми роками у структурі генітальної та екстрагенітальної патології особливе місце посідають різні ендокринопатії, одним із варіантом яких є дефіцит маси тіла (ДМТ) [21][22][23][24][25]. У той самий час вагітні з ДМТ мають підвищений ризик розвитку різних акушерських і перинатальних ускладнень, а існуючі лікувально-профілактичні заходи не завжди ефективні.…”

“…До особливої групи ризику щодо розвитку ПД входять жінки, в яких були ретрохоріальні гематоми (РХГ) у І триместрі вагітності [9][10][11][12][13][14][15][16][17][18]. Останніми роками завдяки широкому впровадженню сучасної ехографічної діагностики підвищується частота діагностованої патології у І триметрі вагітності, у тому числі і РХГ [19][20][21][22][23][24][25].…”

“…Проведення гістеректомії також було пов'язано зі значним зниженням ризику епітеліального раку яєчників ІІ типу (повністю кореговане відношення шансів 0,81; 95% ДІ 0,68-0,96). Повністю кореговане відношення шансів для епітеліального раку яєчників типу ІІ після перев'язки маткових труб становило 0,80 (95% ДІ 0,57-1,11) [24].…”

The Endometriotic Neoplasm Algorithm for Risk Assessment (e-NARA) Index Sheds Light on the Discrimination of Endometriosis-Associated Ovarian Cancer from Ovarian Endometrioma

“…Type 1 tumors show a stepwise progression (adenoma–carcinoma sequence), which comprises endometriosis-associated ovarian cancer (EAOC), such as clear cell carcinoma (CCC) and low-grade endometrioid carcinoma, as well as mucinous carcinoma and low-grade serous carcinoma [ 15 , 16 ]. Type 2 tumors range from the normal epithelium to precursor lesions, and, finally, to high-grade serous and endometrioid carcinoma, malignant mixed mesodermal tumors (carcinosarcomas), and undifferentiated carcinoma [ 15 , 17 ]. The former shows slow, and the latter fast, progression to advanced stages [ 18 , 19 ].…”

Hysterectomy and risk of epithelial ovarian cancer by histologic type, endometriosis, and menopausal hormone therapy

“…It has been suggested that hysterectomy protects against ovarian cancer by blocking transfer of carcinogenic agents, and retrograde menstruation or endometriosis travelling through the female genital tract [3][4][5]. A number of studies have investigated the association between hysterectomy and risk of ovarian cancer with inconsistent ndings [4][5][6][7][8][9][10][11][12][13][14][15]. A meta-analysis observed a time-dependent trend in ndings and pointed out that one explanation could be changes over time in use of menopausal hormone therapy (MHT) [13].…”