The potential for opportunistic salpingectomy to reduce ovarian cancer in women undergoing non-gynecologic surgery

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-02-14 DOI:10.1016/j.gore.2025.101685

Ian C. Cook , Sarah E. Podwika , Peter T. Hallowell , Mark R. Conaway , Charles N. Landen

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引用次数: 0

Abstract

Background

We sought to estimate the impact, acceptance, and additional cost of opportunistic bilateral salpingectomy (OBS) or bilateral salpingo-oophorectomy (BSO) during certain non-gynecologic procedures on the incidence of high grade serous ovarian cancer (HGSOC).

STUDY DESIGN: US population and institutional data were reviewed for three common laparoscopic non-gynecologic surgeries: Cholecystectomy (CCY), Ventral Hernia Repair (VHR), and Bariatric Surgical Procedures (BSP). Additionally, institutional review was performed on all patients, aged 35–75, undergoing these procedures from July 2016 to June 2019 to determine candidacy for OBS or BSO. Patients with history of hysterectomy or tubal sterilization were excluded. Baseline population risk (1.4%) and estimated risk reduction associated with OBS (65%) and BSO (98%) were applied to determine the impact OBS or BSO would have on incidence if applied as standard of care. Separately, patients were surveyed regarding acceptance of concurrent risk reducing procedure. Cost effective analysis (CEA) was performed using multiple models which evaluated participation of Surgery, OB/GYN, and both.

Results

For the institutional review, 765 cases were identified, with 417 eligible. Extrapolating the percentage of eligible female patients from our institution undergoing CCY (63 %), VHR (57 %), and BSP (81 %) to reported annual US cases, resulted in eligible cases as follows: CCY (472,500), VHR (199,500–285,000), and BSP (184,680). Therefore, we estimate 466,891–––513,488 eligible patients per year. Assuming 20,400 new ovarian cancer (OC) cases annually, between 4,248 and 4,839 cases would be eliminated (20.8–23.7 % reduced incidence). Fifty-nine patients were surveyed (13 AA, 2H) with acceptance rate of 81 %. CEA revealed that multiple models for institution of this practice would favor implementing risk reducing surgery, with OBS performing better than BSO.

Conclusion

Over half of female patients undergoing three common non-gynecologic abdominal surgeries could benefit from OBS or BSO. If logistics can be arranged between surgeons and their patients, incidence of OC could be reduced by at least 20–25%.

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机会性输卵管切除术在接受非妇科手术的妇女中减少卵巢癌的可能性

本研究旨在评估在某些非妇科手术中，机会性双侧输卵管切除术（OBS）或双侧输卵管-卵巢切除术（BSO）对高级别浆液性卵巢癌（HGSOC）发病率的影响、接受度和额外费用。研究设计：回顾了三种常见的腹腔镜非妇科手术的美国人群和机构数据：胆囊切除术（CCY）、腹疝修补术（VHR）和减肥外科手术（BSP）。此外，对2016年7月至2019年6月期间接受这些手术的所有35-75岁患者进行机构审查，以确定OBS或BSO的候选资格。排除有子宫切除或输卵管绝育史的患者。基线人群风险（1.4%）和与OBS相关的估计风险降低（65%）和BSO（98%）被应用于确定OBS或BSO作为标准治疗对发病率的影响。另外，对患者进行了关于接受同时降低风险手术的调查。成本效益分析（CEA）采用多种模型评估外科、妇产科和两者的参与情况。结果在机构评价中，共发现765例，其中417例符合条件。将我院接受CCY（63%）、VHR（57%）和BSP（81%）的符合条件的女性患者的比例外推至美国报告的年度病例，得出符合条件的病例如下：CCY（472,500）、VHR（199,500-285,000）和BSP（184,680）。因此，我们估计每年有466,891 - 513,488名符合条件的患者。假设每年有20,400例卵巢癌（OC）新发病例，将消除4,248 - 4,839例（发病率降低20.8 - 23.7%）。共调查59例患者（AA 13例，h 2例），满意率81%。CEA显示，这种做法的多种模式有利于实施降低风险的手术，OBS的表现优于BSO。结论接受三种常见的非妇科腹部手术的女性患者中，有一半以上的患者能从OBS或BSO中获益。如果外科医生和患者之间的后勤安排，OC的发生率可以减少至少20-25%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.