Tubal Ligation and Salpingectomy and the Risk of Epithelial Ovarian Cancer and Borderline Ovarian Tumors: A Nationwide Case-Control Study

ABSTRACT: It was long believed that epithelial cancer originated in the ovarian surface epithelium. Recent studies, however, have shown that its origin is extraovarian, with tumor cells subsequently migrating to the ovary. Current theories on origin of ovarian cancer histologic subtypes suggest that serous tumors develop from the fallopian tube, whereas endometrioid and clear cell tumors originate from the endometrium. If tubal ligation prevents the migration of endometrial tissue through the fallopian tube, the largest risk reduction could be expected for endometrioid and clear cell ovarian cancers. Two meta-analyses and 2 large case-control studies found that tubal ligation was more protective for endometrioid and clear cell tumors than with the other subtypes of epithelial ovarian cancer. Given that serous ovarian cancer originates in the fallopian tube, bilateral salpingectomy may represent a potential opportunity for surgical prevention of serous ovarian cancer, with preservation of ovarian hormone production. This large nationwide register-based case-control study investigated the role of the tubal ligation and salpingectomy in the etiology of epithelial ovarian cancer and borderline ovarian tumors. All women in Denmark diagnosed with epithelial ovarian cancer (n = 13, 241) or borderline ovarian tumors (n = 3605) between 1982 and 2011 were identified. Analyses were stratified according to histologic subtype: epithelial ovarian cancer or borderline ovarian tumor. Control...
Source: Obstetrical and Gynecological Survey - Category: OBGYN Tags: Gynecology: Operative Gynecology Source Type: research