Quantifying opportunities to reduce high grade serous ovarian cancer via opportunistic salpingectomy

To estimate the proportion of patients diagnosed with high-grade serous ovarian cancer (HGSOC) who had prior abdominal or pelvic surgery and may have benefited from opportunistic salpingectomy.

This retrospective cohort study used a single institution's Outcomes in Epithelial Ovarian Cancer research database to identify patients diagnosed with HGSOC from 2014 to 2021. Data abstracted from electronic medical records included demographics, FIGO stage, HBOC testing, prior abdominal and pelvic surgeries, index surgery subspecialty, and surgical mode (open vs minimally invasive). Eligible surgeries occurred ≥6 months before diagnosis, were non-emergent, and performed after childbearing completion (assumed in those ≥45 years, after permanent sterilization, or following last childbirth). Descriptive statistics were used.

Among 605 patients with HGSOC, 342 (56.5 %) had ≥1 prior abdominal or pelvic surgery. There were 500 unique index surgical episodes with a median of 30.0 years (IQR 19.4-37.7) between the first index surgery and HGSOC diagnosis. Most index surgeries were performed by gynecology (59.4 %) or general surgery (35.2 %). The most common gynecologic procedure was tubal ligation (98/297; 33.0 %), and the most common general surgery procedure was cholecystectomy (94/176; 53.4 %).

Nearly 60 % of patients with HGSOC had a prior surgical opportunity for risk reduction via opportunistic salpingectomy, often decades before diagnosis. Future studies should explore incorporating salpingectomy into non-gynecologic surgeries to expand ovarian cancer risk reduction for average-risk women.