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Ovarian cancer risk reduction by salpingectomy during non-gynaecological surgery: scoping review
Charlotte Fisch1, Malou E Gelderblom1, Rosella P M G Hermens2
1Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Background:
Ovarian cancer is the leading cause of death among gynaecological cancers. The identification of the fallopian tube epithelium as the origin of most ovarian cancers introduces a novel prevention strategy by removing the fallopian tubes during an already indicated abdominal surgery for another reason, also known as an opportunistic salpingectomy. This preventive opportunity is evidence based, recommended and established at the time of gynaecologic surgery in many countries worldwide. To expand interest among surgeons in performing a salpingectomy during non-gynaecological surgery, the aim of this review is to identify knowledge gaps during those surgeries.
Methods:
A scoping review was performed following the PRISMA-Scoping Review (ScR) checklist. PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) database and Cochrane Library were systematically searched from inception to November 2024. Trial registers were searched for ongoing trials. All studies reporting original data on salpingectomy during non-gynaecological surgery were included. Outcomes were provided narratively.
Results:
Eighteen studies were identified reporting on the implementation, surgical feasibility, patients' perspectives, physicians' knowledge and cost-effectiveness of an opportunistic salpingectomy during non-gynaecological surgery. Population-level data indicate that an opportunistic salpingectomy is rarely performed in non-gynaecological surgeries. High success rates and no complications of an opportunistic salpingectomy were observed during bariatric surgery and cholecystectomies. However, performing an additional salpingectomy appeared more time-consuming. Patients had strong interest in information on and willingness to undergo opportunistic salpingectomy. Cost-effectiveness analysis encourages opportunistic salpingectomy use, as models show reduced ovarian cancer incidence and mortality rate while being cost-effective.
Conclusions:
Opportunistic salpingectomy during non-gynaecologic surgery appears to be a promising method to prevent ovarian cancer. Implementing such a strategy will require education of multiple surgical disciplines, training and resolution of organizational issues.
Insights
Opportunistic salpingectomy during non-gynecologic surgery is a promising ovarian cancer prevention strategy. Further education and training are needed to increase its implementation in non-gynecologic procedures.
Area of Science:
- Gynecologic Oncology
- Surgical Innovation
- Preventive Medicine
Background:
- Ovarian cancer is the leading cause of gynecologic cancer mortality.
- The fallopian tube is the origin of most ovarian cancers, enabling prevention via salpingectomy.
- Opportunistic salpingectomy during gynecologic surgery is an established preventive strategy.
Purpose of the Study:
- To identify knowledge gaps for performing salpingectomy during non-gynecologic surgery.
- To assess the feasibility and potential of opportunistic salpingectomy in a broader surgical context.
Main Methods:
- A comprehensive scoping review adhering to PRISMA-ScR guidelines.
- Systematic searches of major databases (PubMed, Embase, Web of Science, CINAHL, Cochrane) up to November 2024.
- Inclusion of all studies reporting original data on salpingectomy during non-gynecologic surgery.
Main Results:
- Eighteen studies reported on implementation, feasibility, patient/physician perspectives, and cost-effectiveness.
- Opportunistic salpingectomy is rarely performed during non-gynecologic surgeries, despite high success rates in bariatric and cholecystectomy procedures.
- Patients show strong interest; cost-effectiveness models support reduced ovarian cancer incidence and mortality.
Conclusions:
- Opportunistic salpingectomy during non-gynecologic surgery is a viable ovarian cancer prevention method.
- Implementation requires interdisciplinary education, surgical training, and addressing organizational challenges.
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