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Archives of Gynecology and Obstetrics

, Volume 292, Issue 1, pp 231–234 | Cite as

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

  • Martin Pölcher
  • Steffen Hauptmann
  • Christina Fotopoulou
  • Barbara Schmalfeldt
  • Ivo Meinhold-Heerlein
  • Alexander Mustea
  • Ingo Runnebaum
  • Jalid Sehouli
Position Statements and Guidelines

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.

Keywords

Prophylactic salpingectomy Opportunistic salpingectomy Serous tubal intra-epithelial carcinoma BRCA Serous high-grade ovarian cancer Cancer prevention Hysterectomy 

Notes

Conflict of interest

The authors declare no conflict of interests.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Martin Pölcher
    • 1
  • Steffen Hauptmann
    • 2
  • Christina Fotopoulou
    • 3
  • Barbara Schmalfeldt
    • 4
  • Ivo Meinhold-Heerlein
    • 5
  • Alexander Mustea
    • 6
  • Ingo Runnebaum
    • 7
  • Jalid Sehouli
    • 8
  1. 1.Rotkreuzklinikum MünchenFrauenklinikMünchenGermany
  2. 2.Krankenhaus DürenInstitut und Praxisgemeinschaft für PathologieDürenGermany
  3. 3.West London Gynaecological Cancer Centre and Ovarian Cancer Action Research CentreImperial College Healthcare Trust London, Hammersmith CampusLondonUK
  4. 4.Frauenklinik und PoliklinikKlinikum Rechts der Isar der Technischen Universität MünchenMünchenGermany
  5. 5.Klinik für Gynäkologie und GeburtsmedizinUniklinik RWTH AachenAachenGermany
  6. 6.Klinik und Poliklinik für Frauenheilkunde und GeburtshilfeUniversitätsmedizin GreifswaldGreifswaldGermany
  7. 7.Klinik für Frauenheilkunde und GeburtshilfeUniversitätsklinikum JenaJenaGermany
  8. 8.European Competence Center for Ovarian CancerCharité Medical University of BerlinBerlinGermany

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