Growing Acceptance of Removing Fallopian Tubes But Keeping Ovaries to Lower Ovarian Cancer Risk
May 8, 2013
New Orleans, LA -- Patients and physicians are showing a growing acceptance of routinely removing the fallopian tubes but preserving the ovaries during hysterectomy, according to new research presented today at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists. Removing just the fallopian tubes during hysterectomy may lower the risk of developing the most common type of ovarian cancer, researchers said.
Bilateral salpingectomy, the removal of both fallopian tubes while preserving the ovaries, is considered a safe way of potentially reducing the development of ovarian serous carcinoma, the most common type of ovarian cancer. Increasing evidence points toward the fallopian tubes as the origin of this type of cancer. Removing the fallopian tubes does not cause the onset of menopause, as does removal of the ovaries.
This study, led by investigators Christine H. Holschneider, MD, and Susan K. Park, MD, at Olive View-UCLA Medical Center in Los Angeles, CA, assessed physician and patient acceptance of the bilateral salpingectomy procedure during hysterectomy. The study also looked into the feasibility of a department-wide practice to offer and perform bilateral salpingectomy at the time of hysterectomy while preserving the ovaries. “We also wanted to confirm that bilateral salpingectomy added no significant additional risk to hysterectomy,” said Dr. Park.
The researchers conducted a retrospective study of women who underwent an abdominal, vaginal, or laparoscopic hysterectomy with ovarian preservation at Olive View-UCLA Medical Center between January 2009 and June 2012. They reviewed medical records for 1,060 patients and collected data on these women about being offered bilateral salpingectomy as well as actual completion of the procedure at the time of hysterectomy.
All but two patients who were offered salpingectomy in the study consented. Six of the consenting patients could not have the procedure due to complications. Bilateral salpingectomy rates rose from 3% in 2009 and 2010 to 33% in 2011 and 77% in the first six months of 2012.
According to Dr. Park, there appears to be no increased risk with salpingectomy at the time of hysterectomy with ovarian preservation compared with hysterectomy alone. “There is high patient and provider acceptance of this practice,” Dr. Park said. “Our study aids physicians in assuring patients that there does not appear to be any increased risk of surgical complications associated with performing salpingectomy at time of hysterectomy.”
This study does not address the possible role or risks and benefits of salpingectomy in patients undergoing tubal sterilization procedures or the role of salpingectomy in women with a genetic predisposition to ovarian cancer. “We studied only surgical morbidity,” Dr. Park said. “We did not study the important long-term outcomes, such as the risks of developing post-hysterectomy adnexal masses or cancers. Such a study is an important next step but would need to be done at a much larger scale than a single institution study.”
*Wednesday Paper #1: Incorporating Routine Bilateral Salpingectomy at the Time of Hysterectomy with Ovarian Preservation
The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 57,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org