Related Experiment Video
Updated: Dec 6, 2025
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Salpingectomy for the Risk Reduction of Ovarian Cancer: Is It Time for a Salpingectomy-alone Approach?
Thomas Boerner1, Kara Long Roche1
1Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center (all authors); Department of Obstetrics and Gynecology, Weill Cornell Medical College (Dr. Long Roche), New York, New York.
Objective:
To summarize published evidence supporting current strategies for the prevention of epithelial ovarian cancer in women with a genetic, elevated risk for the development of this disease, as well as the emerging data on the novel salpingectomy with delayed oophorectomy (SDO) strategy. Furthermore, we will explore whether salpingectomy alone is a viable risk-reducing strategy for these women. We will also discuss current national guidelines for risk-reducing surgery based on patients' individual genetic predisposition.
Data Sources:
MEDLINE, PubMed, EMBASE, and the Cochrane Database, with a focus on randomized controlled trials and large prospective, observational studies.
Methods Of Study Selection:
The key search terms for our review included Medical Subject Headings: "salpingectomy," "ovarian cancer," and "risk-reducing surgery."
Tabulation, Integration, And Results:
The fallopian tube is now well established as the site of origin for most ovarian cancers, particularly high-grade serous carcinomas. This finding has led to the development of new preventive surgical techniques, such as SDO, which may be associated with fewer side effects. However, until the results of ongoing trials are reported and the impact of SDO on ovarian cancer risk reduction is established, it should not be recommended outside of clinical trials, and bilateral salpingo-oophorectomy remains the treatment of choice for risk-reducing surgery, especially in women with a genetic, high risk for ovarian cancer.
Conclusion:
The decision to undergo risk-reducing surgery among women with an elevated risk for ovarian cancer should be made after comprehensive consultation and individually based on genetic predisposition, childbearing status, and personal preference.
Insights
For women at high genetic risk of ovarian cancer, bilateral salpingo-oophorectomy is the current standard for risk-reducing surgery. Salpingectomy with delayed oophorectomy (SDO) is promising but requires more data before widespread recommendation.
Area of Science:
- Gynecologic Oncology
- Preventive Medicine
- Surgical Innovation
Background:
- Most ovarian cancers, especially high-grade serous carcinomas, originate in the fallopian tubes.
- This understanding has spurred the development of novel preventive surgical strategies.
- Salpingectomy with delayed oophorectomy (SDO) is an emerging technique with potential for fewer side effects.
Purpose of the Study:
- To review evidence for current ovarian cancer prevention strategies in genetically high-risk women.
- To evaluate emerging data on salpingectomy with delayed oophorectomy (SDO).
- To explore salpingectomy alone as a risk-reducing option and discuss national guidelines.
Main Methods:
- Comprehensive literature search of MEDLINE, PubMed, EMBASE, and Cochrane Database.
- Focused on randomized controlled trials and large prospective, observational studies.
- Key search terms included "salpingectomy," "ovarian cancer," and "risk-reducing surgery."
Main Results:
- Bilateral salpingo-oophorectomy remains the recommended treatment for risk-reducing surgery in high-risk women.
- SDO shows promise but requires further evidence from ongoing trials before clinical recommendation outside of trials.
- Salpingectomy alone as a risk-reducing strategy requires additional investigation.
Conclusions:
- The decision for risk-reducing surgery should be individualized.
- Considerations include genetic predisposition, childbearing status, and patient preferences.
- Comprehensive consultation is essential for informed decision-making.
