Opportunistic salpingectomy for prevention of sporadic ovarian cancer - a jump from basic science to clinical practice?

Abstract

Ovarian cancer is the most malignant and aggressive gynecological cancer. Due to nonspecific symptoms in the early stage and a lack of effective screening methods, it is typically diagnosed at an advanced stage. The high-grade serous cancer (HGSC) represents 75% of all ovarian cancers and accounts for the majority of deaths. Contemporary thought suggests that precursor lesions of HGSC originate in the fallopian tube. The presumed precursor tubal lesion, localized at the fimbrial end of the fallopian tubes, is termed the serous tubal intraepithelial carcinoma (STIC). Thus, removal of the fallopian tubes at the time of pelvic or abdominal surgery for a benign condition (i.e. opportunistic salpingectomy) appears as an attractive option for primary prevention of HGSC. This paper presents the scientific background of opportunistic salpingectomy and discusses controversies regarding the benefits and safety of the procedure.