Efficacy of salpingectomy at hysterectomy to reduce the risk of epithelial ovarian cancer: a systematic review

BJOG. 2017 May;124(6):880-889. doi: 10.1111/1471-0528.14601.


Background: It has been argued that salpingectomy would reduce the risk of epithelial ovarian cancer (EOC), based on the theory of the tube being the site of origin.

Objectives: To conduct a systematic review of 'salpingectomy' associated with ovarian cancer risk and 'salpingectomy with concomitant hysterectomy' on outcomes of complications including endocrine function.

Search strategy: A comprehensive search was conducted in PubMed, Embase, and the Cochrane library.

Selection criteria: Original studies and systematic reviews were eligible.

Data collection and analysis: Each article was quality assessed. Data were extracted and, when possible, pooled in meta-analyses. The certainty of evidence across studies was evaluated using GRADE.

Main results: Of 844 articles found, 11 were included. No study evaluated risk reduction for EOC after salpingectomy in conjunction with hysterectomy. Two retrospective studies reported a reduced ovarian cancer risk after indicated salpingectomy, compared with no surgery: adjusted hazard ratio 0.65 (95% confidence interval, 95% CI 0.52-0.81) and adjusted odds ratio 0.58 (95% CI 0.36-0.95). Complications did not differ between groups with or without salpingectomy, but were non-systematically reported. Ovarian endocrine function, measured with surrogate outcomes, did not differ at short-term follow-up in randomised or observational studies. The certainty of evidence was very low or low for all outcomes.

Conclusions: There is currently insufficient evidence to state that opportunistic salpingectomy reduces the risk of EOC. The impact on long-term endocrine function is unknown. The heterogeneity in results and identified knowledge gaps stress the need for a prospective trial.

Tweetable abstract: Insufficient evidence for prophylactic removal of the fallopian tubes for risk reduction of ovarian cancer.

Keywords: Hysterectomy; opportunistic salpingectomy; ovarian cancer risk reduction.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Carcinoma, Ovarian Epithelial / etiology
  • Carcinoma, Ovarian Epithelial / prevention & control*
  • Female
  • Humans
  • Hysterectomy / methods*
  • Middle Aged
  • Odds Ratio
  • Ovarian Neoplasms / etiology
  • Ovarian Neoplasms / prevention & control*
  • Prophylactic Surgical Procedures / methods*
  • Risk Factors
  • Salpingectomy / methods*
  • Treatment Outcome