Risk-Reducing Salpingectomy as Preventative Strategy for Pelvic Serous Cancer

Anderson, Charles; Wallace, Shannon L.; Guiahi, Maryam; Sheeder, Jeanelle; Behbakht, Kian; Spillman, Monique A.

doi:10.1097/igc.0b013e3182849dba

Cited by 36 publications

(22 citation statements)

References 43 publications

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“…65,66 In many cases of ovarian cancer, there is an in situ lesion in the fallopian tube; however, in these cases, the tumor is predominantly a serous surface papillary lesion of the peritoneum and the involvement of the fallopian tube epithelium could be explained by multicentricity. Another important consideration is that we do not know whether salpingectomy affects the blood or lymphatic circulation of the ovary, putting patients at risk for secondary manifestations related to hormonal effects.…”

Section: Fere Ex Nihilo Theorymentioning

confidence: 97%

The Origin of Epithelial Neoplasms of the Ovary

Silva

2016

Advances in Anatomic Pathology

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Several theories have been proposed to explain the origin of epithelial neoplasms of the ovary. However, most of them did not receive serious consideration until recently when it has been proposed that most ovarian neoplasms arise from the fallopian tube. In this review, we mention the different theories, we discuss in detail the fallopian tube theory, and the reasons why this theory is probably inaccurate. We are also proposing a new theory, the fere ex nihilo, based on the observation of numerous cases, old and new concept, and experimental works with animals. We believe that, most probably, ovarian epithelial neoplasms are related to hormones and the identification of these hormones will allow us not only to diagnose and treat these lethal neoplasms, but also to prevent them.

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Section: Fere Ex Nihilo Theorymentioning

confidence: 97%

The Origin of Epithelial Neoplasms of the Ovary

Silva

2016

Advances in Anatomic Pathology

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“…[12] The most lethal ovarian malignancy is serous carcinoma that initially forms in the distal mucosal part of the fallopian tube and will extend to ovaries and other pelvic organs. [2345] Because the hypothesis of the possible effect of salpingectomy in ovarian cancer prophylaxis is designed. [67] Since not having any special screening test for ovarian cancer and high rate of diagnosis in late stages, this hypothesis can play an important role.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of ovarian function after hysterectomy with or without salpingectomy: A feasible study

Behnamfar

Jabbari

2017

J Res Med Sci

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Background:Prophylactic salpingectomy for the prevention of ovarian cancer has been recommended strongly. The aim of this study was to compare ovarian function in patients who undergo hysterectomy for benign reasons with or without bilateral salpingectomy.Materials and Methods:This was a clinical-trial study on patients undergone hysterectomy with/without bilateral salpingectomy in Al-Zahra Hospital, in 2015–2016. Demographic information (age, height, and weight) were recorded. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured in 2–5 days of menstrual cycle before operation. Patients were asked to refer in 6 months for follow-up, including FSH and LH re-measurement and also menopausal status examination. Patients were divided into age groups of 39–45, 46–50, and ≥51 and also groups of body mass index including 18.5–24.9, 25–29.9, and 30–34.9.Results:A total of 37 patients divided into two groups, including 22 patients undergone hysterectomy without salpingectomy (H) and 15 undergone hysterectomy with bilateral salpingectomy (H-bS). The mean age (standard deviation) of Group H was 47.77 (3.03) and Group H-bS was 48.47 (2.03) (P > 0.05). Furthermore, the mean level of FSH and LH before surgery was not significantly different (P > 0.05). The mean level of FSH and LH changes was not significant between H and H-bS groups (P = 0.17), (P = 0.16).Conclusion:Bilateral salpingectomy during hysterectomy did not increase the risk of ovarian dysfunction after 6 months follow-up.

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“…This theory, along with the risks associated with early menopause, has brought increasing interest to the role of salpingectomy with delayed oophorectomy (PSDO) as a potential alternative to RRSO for BRCA mutation carriers. [24, 25]…”

Section: Introductionmentioning

confidence: 99%

Acceptability of prophylactic salpingectomy with delayed oophorectomy as risk-reducing surgery among BRCA mutation carriers

Holman¹,

Friedman²,

Daniels³

et al. 2014

Gynecologic Oncology

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OBJECTIVE Given emerging evidence for the fimbria as the site of origin for many serous carcinomas in BRCA mutation carriers, consideration is being given to studying prophylactic salpingectomy with delayed oophorectomy (PSDO) as risk-reducing surgery. We aimed to determine the interest in a study of PSDO among these women. METHODS We evaluated the results of an online survey conducted by Facing Our Risk of Cancer Empowered (FORCE), a patient advocacy group, from October 2010 to August 2012. Premenopausal BRCA mutation carriers with no history of ovarian cancer or prior bilateral salpingo-oophorectomy (BSO) were included. RESULTS Of the 204 women meeting inclusion criteria, median age was 35 years, 92.5% were white, 25.7% Jewish, and 16.7% had a history of breast cancer. Overall, 34.3% reported interest in a study of salpingectomy, 35.3% were unsure, and 30.4% were not interested in the study. Women noted the possibility of lowering ovarian cancer risk without menopause as a compelling reason to participate (83.8%). Reasons for not participating in a salpingectomy study included surgical complications (46.6%), potential ovarian damage (42.2%), planning BSO soon (32.4%), and surgical costs (32.8%). Acceptable study risks included the need for two surgeries (77.2%), possibility of not lowering ovarian cancer risk (68%), and disruption of ovarian blood supply (66.5%). CONCLUSIONS One-third of BRCA mutation carriers indicated definite interest in a PSDO study. Potential study risks were acceptable to most women. These findings suggest that patient accrual for a clinical trial of prophylactic salpingectomy with delayed oophorectomy is possible.

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Risk-Reducing Salpingectomy as Preventative Strategy for Pelvic Serous Cancer

Cited by 36 publications

References 43 publications

The Origin of Epithelial Neoplasms of the Ovary

The Origin of Epithelial Neoplasms of the Ovary

Evaluation of ovarian function after hysterectomy with or without salpingectomy: A feasible study

Acceptability of prophylactic salpingectomy with delayed oophorectomy as risk-reducing surgery among BRCA mutation carriers

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