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Prophylactic oophorectomy in ovarian cancer prevention
A Kontoravdis1, D Kalogirou, G Antoniou
12nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece.
Objective:
To evaluate prophylactic oophorectomy in the prevention of ovarian cancer.
Method:
Between 1970 and 1990, 5262 hysterectomies were performed at Areteion Hospital, Athens.
Results:
Ovarian cancer was subsequently diagnosed in 520 women (9.9%). The mean interval from hysterectomy to diagnosis of ovarian cancer was 7.2 years. If prophylactic bilateral oophorectomy had been practiced routinely in women undergoing hysterectomy at age 40 or above, 9.4% of cases would have been prevented.
Conclusion:
We recommend bilateral oophorectomy for all women with a positive family history of ovarian carcinoma and for all women undergoing hysterectomy after the age of 40. The decision for prophylactic oophorectomy as a complementary procedure to other indicated gynecologic surgeries should depend on the individual patient and her ability to comply with lifelong estrogen replacement therapy.