Prophylactic salpingectomy and ovarian cancer: An evidence-based analysis

Tricia Dewi Anggraeni; Adly Nanda Al Fattah; Surya Raymond

doi:10.4103/sajc.sajc_187_17

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ORIGINAL ARTICLE: Genitourinary & Gynaecological Cancer

07 (

); 42-45

doi:

10.4103/sajc.sajc_187_17

Prophylactic salpingectomy and ovarian cancer: An evidence-based analysis

Tricia Dewi Anggraeni¹, Adly Nanda Al Fattah¹, Surya Raymond^1,

1 Department of Radiotherapy, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat

*Corresponding author: Dr. Raymond Surya. raymond_s130291@yahoo.co.id

Published: 2020-12-22

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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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.

Keywords

References

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86.
Tanner EJ, Long KC, Visvanathan K, Fader AN. Prophylactic salpingectomy in premenopausal women at low risk for ovarian cancer: Risk-reducing or risky? Fertil Steril 2013;100:1530-1.
Vang R, Shih IeM, Kurman RJ. Fallopian tube precursors of ovarian low- and high-grade serous neoplasms. Histopathology 2013;62:44-58.
Pölcher M, Hauptmann S, Fotopoulou C, Schmalfeldt B, Meinhold-Heerlein I, Mustea A, et al. Opportunistic salpingectomies for the prevention of a high-grade serous carcinoma: A statement by the Kommission Ovar of the AGO. Arch Gynecol Obstet 2015;292:231-4.
Greene MH, Mai PL, Schwartz PE. Does bilateral salpingectomy with ovarian retention warrant consideration as a temporary bridge to risk-reducing bilateral oophorectomy in BRCA1/2 mutation carriers? Am J Obstet Gynecol 2011;204:19.e1-6.
Oliver Perez MR, Magriñá J, García AT, Jiménez Lopez JS. Prophylactic salpingectomy and prophylactic salpingoophorectomy for adnexal high-grade serous epithelial carcinoma: A reappraisal. Surg Oncol 2015;24:335-44.
Salpingectomy for ovarian cancer prevention. Committee Opinion No. 620. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;125:279–81
Ziętek A, Bogusiewicz M, Szumiło J, Rechberger T. Opportunistic salpingectomy for prevention of sporadic ovarian cancer – A jump from basic science to clinical practice? Ginekol Pol 2016;87:467-72.
Falconer H, Yin L, Grönberg H, Altman D. Ovarian cancer risk after salpingectomy: A nationwide population-based study. J Natl Cancer Inst 2015;107. pii: dju410.
Dilley SE, Havrilesky LJ, Bakkum-Gamez J, Cohn DE, Michael Straughn J Jr., Caughey AB, et al. Cost-effectiveness of opportunistic salpingectomy for ovarian cancer prevention. Gynecol Oncol 2017;146:373-9.
Kwon JS, McAlpine JN, Hanley GE, Finlayson SJ, Cohen T, Miller DM, et al. Costs and benefits of opportunistic salpingectomy as an ovarian cancer prevention strategy. Obstet Gynecol 2015;125:338-45.
Lessard-Anderson CR, Handlogten KS, Molitor RJ, Dowdy SC, Cliby WA, Weaver AL, et al. Effect of tubal sterilization technique on risk of serous epithelial ovarian and primary peritoneal carcinoma. Gynecol Oncol 2014;135:423-7.
Madsen C, Baandrup L, Dehlendorff C, Kjaer SK. Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors: A nationwide case-control study. Acta Obstet Gynecol Scand 2015;94:86-94.
Yoon SH, Kim SN, Shim SH, Kang SB, Lee SJ. Bilateral salpingectomy can reduce the risk of ovarian cancer in the general population: A meta-analysis. Eur J Cancer 2016;55:38-46.
Findley AD, Siedhoff MT, Hobbs KA, Steege JF, Carey ET, McCall CA, et al. Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial. Fertil Steril 2013; 100:1704-8.
Venturella R, Lico D, Borelli M, Imbrogno MG, Cevenini G, Zupi E, et al. 3 to 5 Years later: Long-term effects of prophylactic bilateral salpingectomy on ovarian function. J Minim Invasive Gynecol 2017;24:145-50.
Antosh DD, High R, Brown HW, Oliphant SS, Abed H, Philip N, et al. Feasibility of prophylactic salpingectomy during vaginal hysterectomy. Am J Obstet Gynecol 2017;217:605.e1-0000.
Vorwergk J, Radosa MP, Nicolaus K, Baus N, Jimenez Cruz J, Rengsberger M, et al. Prophylactic bilateral salpingectomy (PBS) to reduce ovarian cancer risk incorporated in standard premenopausal hysterectomy: Complications and re-operation rate. J Cancer Res Clin Oncol 2014;140:859-65.
Venturella R, Rocca M, Lico D, Trapasso S, Di Cello A, Gizzo S, et al. Prophylactic bilateral salpingectomy for the prevention of ovarian cancers: What is happening in Italy? Eur J Cancer Prev 2016;25:410-5.
Potz FL, Tomasch G, Polterauer S, Laky R, Marth C, Tamussino K, et al. Incidental (Prophylactic) salpingectomy at benign gynecologic surgery and cesarean section: A Survey of practice in Austria. Geburtshilfe Frauenheilkd 2016;76:1325-9.
Skorupska KA, Miotła P, Kubik-Komar A, Rechberger E, Adamiak-Godlewska A, Rechberger T, et al. Are there any differences in quality of life and sexual functions after various types of hysterectomy - does prophylactic salpingectomy matter? Ginekol Pol 2016;87:26-31.
Ely LK, Truong M. The role of opportunistic bilateral salpingectomy vs. tubal occlusion or ligation for ovarian cancer prophylaxis. J Minim Invasive Gynecol 2017;24:371-8.

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[1] Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86.

[2] Tanner EJ, Long KC, Visvanathan K, Fader AN. Prophylactic salpingectomy in premenopausal women at low risk for ovarian cancer: Risk-reducing or risky? Fertil Steril 2013;100:1530-1.

[3] Vang R, Shih IeM, Kurman RJ. Fallopian tube precursors of ovarian low- and high-grade serous neoplasms. Histopathology 2013;62:44-58.

[4] Pölcher M, Hauptmann S, Fotopoulou C, Schmalfeldt B, Meinhold-Heerlein I, Mustea A, et al. Opportunistic salpingectomies for the prevention of a high-grade serous carcinoma: A statement by the Kommission Ovar of the AGO. Arch Gynecol Obstet 2015;292:231-4.

[5] Greene MH, Mai PL, Schwartz PE. Does bilateral salpingectomy with ovarian retention warrant consideration as a temporary bridge to risk-reducing bilateral oophorectomy in BRCA1/2 mutation carriers? Am J Obstet Gynecol 2011;204:19.e1-6.

[6] Oliver Perez MR, Magriñá J, García AT, Jiménez Lopez JS. Prophylactic salpingectomy and prophylactic salpingoophorectomy for adnexal high-grade serous epithelial carcinoma: A reappraisal. Surg Oncol 2015;24:335-44.

[7] Salpingectomy for ovarian cancer prevention. Committee Opinion No. 620. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;125:279–81

[8] Ziętek A, Bogusiewicz M, Szumiło J, Rechberger T. Opportunistic salpingectomy for prevention of sporadic ovarian cancer – A jump from basic science to clinical practice? Ginekol Pol 2016;87:467-72.

[9] Falconer H, Yin L, Grönberg H, Altman D. Ovarian cancer risk after salpingectomy: A nationwide population-based study. J Natl Cancer Inst 2015;107. pii: dju410.

[10] Dilley SE, Havrilesky LJ, Bakkum-Gamez J, Cohn DE, Michael Straughn J Jr., Caughey AB, et al. Cost-effectiveness of opportunistic salpingectomy for ovarian cancer prevention. Gynecol Oncol 2017;146:373-9.

[11] Kwon JS, McAlpine JN, Hanley GE, Finlayson SJ, Cohen T, Miller DM, et al. Costs and benefits of opportunistic salpingectomy as an ovarian cancer prevention strategy. Obstet Gynecol 2015;125:338-45.

[12] Lessard-Anderson CR, Handlogten KS, Molitor RJ, Dowdy SC, Cliby WA, Weaver AL, et al. Effect of tubal sterilization technique on risk of serous epithelial ovarian and primary peritoneal carcinoma. Gynecol Oncol 2014;135:423-7.

[13] Madsen C, Baandrup L, Dehlendorff C, Kjaer SK. Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors: A nationwide case-control study. Acta Obstet Gynecol Scand 2015;94:86-94.

[14] Yoon SH, Kim SN, Shim SH, Kang SB, Lee SJ. Bilateral salpingectomy can reduce the risk of ovarian cancer in the general population: A meta-analysis. Eur J Cancer 2016;55:38-46.

[15] Findley AD, Siedhoff MT, Hobbs KA, Steege JF, Carey ET, McCall CA, et al. Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial. Fertil Steril 2013; 100:1704-8.

[16] Venturella R, Lico D, Borelli M, Imbrogno MG, Cevenini G, Zupi E, et al. 3 to 5 Years later: Long-term effects of prophylactic bilateral salpingectomy on ovarian function. J Minim Invasive Gynecol 2017;24:145-50.

[17] Antosh DD, High R, Brown HW, Oliphant SS, Abed H, Philip N, et al. Feasibility of prophylactic salpingectomy during vaginal hysterectomy. Am J Obstet Gynecol 2017;217:605.e1-0000.

[18] Vorwergk J, Radosa MP, Nicolaus K, Baus N, Jimenez Cruz J, Rengsberger M, et al. Prophylactic bilateral salpingectomy (PBS) to reduce ovarian cancer risk incorporated in standard premenopausal hysterectomy: Complications and re-operation rate. J Cancer Res Clin Oncol 2014;140:859-65.

[19] Venturella R, Rocca M, Lico D, Trapasso S, Di Cello A, Gizzo S, et al. Prophylactic bilateral salpingectomy for the prevention of ovarian cancers: What is happening in Italy? Eur J Cancer Prev 2016;25:410-5.

[20] Potz FL, Tomasch G, Polterauer S, Laky R, Marth C, Tamussino K, et al. Incidental (Prophylactic) salpingectomy at benign gynecologic surgery and cesarean section: A Survey of practice in Austria. Geburtshilfe Frauenheilkd 2016;76:1325-9.

[21] Skorupska KA, Miotła P, Kubik-Komar A, Rechberger E, Adamiak-Godlewska A, Rechberger T, et al. Are there any differences in quality of life and sexual functions after various types of hysterectomy - does prophylactic salpingectomy matter? Ginekol Pol 2016;87:26-31.

[22] Ely LK, Truong M. The role of opportunistic bilateral salpingectomy vs. tubal occlusion or ligation for ovarian cancer prophylaxis. J Minim Invasive Gynecol 2017;24:371-8.

Prophylactic salpingectomy and ovarian cancer: An evidence-based analysis

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Abstract

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