Our Summary

This research paper looks at the impact of removing both ovaries and fallopian tubes (a procedure known as bilateral salpingo-oophorectomy) at the same time as performing a hysterectomy for non-cancerous reasons. The aim was to understand if this additional procedure reduces the chances of getting ovarian cancer and dying from it.

The study looked at adult women in Ontario, Canada who had a benign hysterectomy between 1996 and 2010. Women who already had ovarian issues, a history of breast or gynecological cancer, or a genetic predisposition to cancer were not included in the study.

The research found out that having a bilateral salpingo-oophorectomy alongside a hysterectomy does indeed lower the risk of getting ovarian cancer and dying from it. After 20 years, the chance of getting ovarian cancer was 0.08% for those who had the extra operation, compared to 0.46% for those who didn’t. This is an absolute risk reduction of 0.38%, meaning that for every 260 women who have the additional procedure, one case of ovarian cancer is prevented. When the research was restricted to women aged 50 or over at the time of their hysterectomy, the number needed to treat to prevent one case of ovarian cancer dropped to 161.

The authors conclude that removing the ovaries and fallopian tubes at the time of a benign hysterectomy can significantly reduce the chances of getting ovarian cancer. However, they note that these findings should be considered alongside other potential impacts of the extra operation when making decisions about treatment.

FAQs

  1. What is a bilateral salpingo-oophorectomy and why might it be performed alongside a hysterectomy?
  2. How much does a bilateral salpingo-oophorectomy reduce the risk of developing ovarian cancer according to this study?
  3. What factors should be considered when deciding whether or not to have a bilateral salpingo-oophorectomy performed alongside a hysterectomy?

Doctor’s Tip

A doctor might advise a patient considering a salpingo-oophorectomy to discuss the potential benefits and risks of the procedure with their healthcare provider. They may also recommend regular follow-up appointments and screenings to monitor for any potential complications or changes in health. Additionally, the doctor may encourage the patient to maintain a healthy lifestyle, including regular exercise and a balanced diet, to support overall well-being after the surgery.

Suitable For

Patients who are at a higher risk of ovarian cancer, such as those with a family history of ovarian or breast cancer, those with a genetic predisposition to cancer (such as BRCA mutations), or those with a personal history of gynecological cancer, may be recommended for salpingo-oophorectomy. Additionally, women who are undergoing a hysterectomy for non-cancerous reasons and are nearing menopause or are postmenopausal may also be candidates for this procedure to reduce their risk of developing ovarian cancer in the future.

Timeline

Before the salpingo-oophorectomy:

  • Patient undergoes a hysterectomy for non-cancerous reasons
  • Patient is evaluated for any history of ovarian issues, breast or gynecological cancer, or genetic predisposition to cancer
  • Patient is informed about the potential benefits and risks of having a bilateral salpingo-oophorectomy alongside the hysterectomy

After the salpingo-oophorectomy:

  • Patient has a lower risk of developing ovarian cancer
  • After 20 years, the chance of getting ovarian cancer is significantly lower for those who had the additional procedure
  • The absolute risk reduction of getting ovarian cancer is 0.38%
  • The number needed to treat to prevent one case of ovarian cancer varies depending on patient age, with older women benefiting more
  • Patient and healthcare providers should consider the potential impacts of the additional operation when making treatment decisions

What to Ask Your Doctor

Some questions a patient should ask their doctor about salpingo-oophorectomy include:

  1. What are the potential risks and complications associated with a bilateral salpingo-oophorectomy?
  2. How will removing my ovaries and fallopian tubes affect my hormone levels and menopausal symptoms?
  3. Will I need hormone replacement therapy after the procedure?
  4. How will the surgery impact my fertility and options for having children in the future?
  5. Are there any alternative options for reducing my risk of ovarian cancer that do not involve removing my ovaries?
  6. How long is the recovery period after a bilateral salpingo-oophorectomy?
  7. Will removing my ovaries and fallopian tubes have any impact on my overall health and well-being?
  8. How often will I need to follow up with my doctor after the procedure?
  9. Are there any long-term effects or risks associated with having a bilateral salpingo-oophorectomy?
  10. How will this procedure affect my risk of developing other types of cancer, such as breast cancer?

Reference

Authors: Cusimano MC, Ferguson SE, Moineddin R, Chiu M, Aktar S, Liu N, Baxter NN. Journal: Am J Obstet Gynecol. 2022 Feb;226(2):220.e1-220.e26. doi: 10.1016/j.ajog.2021.09.020. Epub 2021 Sep 24. PMID: 34563499