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Opportunistic salpingectomies for the prevention of a high-grade serous carcinoma: a statement by the Kommission Ovar of the AGO

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Abstract

The detection of premalignant cells in the epithelium of the fallopian tube has resulted in revolutionary theories regarding the origin of epithelial ovarian cancer (EOC). Serous tubal intra-epithelial carcinomas (STIC) have been detected in patients with BRCA 1 or 2 mutations and are considered as the most likely precursors of the high-grade serous ovarian cancer (HGSOC), which is the most common histological subtype in patients with EOC. A bilateral salpingo-oophorectomy is associated with a significant reduction in risk of developing EOC. According to various national guidelines, prophylactic bilateral salpingo-oophorectomy should be performed in the age group 40–45 years. As in patients with BRCA mutations, the prophylactic removal of the fallopian tubes is also performed in women without an increased genetic risk, for example, in surgical treatments of benign conditions. There is a current debate as to whether prophylactic or so-called opportunistic salpingectomy will influence the overall incidence of EOC in the coming years. Opponents of this theory warn of a higher surgical morbidity and the higher risk of a premature menopause through impaired vascular supply to the ovaries. The value of opportunistic salpingectomies has not yet been clarified since there are currently no systematic risk–benefit evaluations. This review will attempt to give an overview of the current body of evidence regarding the risks and benefits of opportunistic salpingectomies.

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Conflict of interest

The authors declare no conflict of interests.

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Authors and Affiliations

  1. Rotkreuzklinikum München, Frauenklinik, Taxisstraße 3, 80637, München, Germany

    Martin Pölcher

  2. Krankenhaus Düren, Institut und Praxisgemeinschaft für Pathologie, Roonstraße 30, 52351, Düren, Germany

    Steffen Hauptmann

  3. West London Gynaecological Cancer Centre and Ovarian Cancer Action Research Centre, Imperial College Healthcare Trust London, Hammersmith Campus, London, UK

    Christina Fotopoulou

  4. Frauenklinik und Poliklinik, Klinikum Rechts der Isar der Technischen Universität München, Ismaninger Straße 22, München, Germany

    Barbara Schmalfeldt

  5. Klinik für Gynäkologie und Geburtsmedizin, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

    Ivo Meinhold-Heerlein

  6. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany

    Alexander Mustea

  7. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Jena, Bachstraße 18, 07743, Jena, Germany

    Ingo Runnebaum

  8. European Competence Center for Ovarian Cancer, Charité Medical University of Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Jalid Sehouli

Authors
  1. Martin Pölcher
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  2. Steffen Hauptmann
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  3. Christina Fotopoulou
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  4. Barbara Schmalfeldt
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  5. Ivo Meinhold-Heerlein
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  6. Alexander Mustea
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  7. Ingo Runnebaum
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  8. Jalid Sehouli
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Correspondence to Martin Pölcher.

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Pölcher, M., Hauptmann, S., Fotopoulou, C. 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 292, 231–234 (2015). https://doi.org/10.1007/s00404-015-3697-y

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  • DOI: https://doi.org/10.1007/s00404-015-3697-y

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