Role of prophylactic hysterectomy in patients at high risk for hereditary cancers

Jeannine A. Villella, Madhu Parmar, Kathleen Donohue, Cathy Fahey, M. Steven Piver, Kerry J Rodabaugh

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background.: Current surgical recommendations for ovarian cancer prophylaxis in women at high risk of developing ovarian cancer include bilateral salpingo-oophorectomy (risk-reducing salpingo-oophorectomy (RRSO)). The role of hysterectomy is unclear. We sought to determine outcomes following prophylactic surgery in high-risk women. Methods.: We surveyed unaffected members of the Gilda Radner Familial Ovarian Cancer Registry who had undergone oophorectomy from 1981 to 2002. Data were collected and analyzed for statistical significance by the Fisher's Exact Test. Results.: Two hundred eighty women were surveyed, and 154 (55%) responded; 97% were Caucasian and 14% reported being Jewish. The median age of the respondents was 51 years (range 29-79); median age at oophorectomy was 41 years (range 15-68). Fifty-eight patients (38%) reported a laparoscopic procedure. One hundred five patients (68%) had a simultaneous hysterectomy, and 4 (3%) had a prior hysterectomy. Forty-four patients (29%) underwent BSO only. Of these 44 patients, 40 (91%) did not require a subsequent hysterectomy. Of the 4 who did, 2 were for leiomyomas, one for menorrhagia and the other was unknown. While not statistically significant, of the 3 patients who developed a subsequent gynecologic malignancy, all had undergone a hysterectomy. There was a statistically significant difference in whether or not the uterus was removed as part of the procedure by time period, whereby women treated prior to 1990 had a higher likelihood of having a hysterectomy (P = 0.03). Conclusion.: The women in our study did not require hysterectomy for prevention of malignancy. We conclude that one should screen for benign gynecological indications for hysterectomy when planning a prophylactic BSO for prevention of ovarian cancer. Other potential risk factors for endometrial cancer, including the role of UPSC in HBOC, remain to be elucidated.

Original languageEnglish (US)
Pages (from-to)475-479
Number of pages5
JournalGynecologic Oncology
Volume102
Issue number3
DOIs
StatePublished - Sep 1 2006

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Hysterectomy
Ovariectomy
Ovarian Neoplasms
Neoplasms
Menorrhagia
Leiomyoma
Endometrial Neoplasms
Uterus
Registries

Keywords

  • Familial ovarian cancer
  • Hysterectomy
  • Prophylactic oophorectomy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Role of prophylactic hysterectomy in patients at high risk for hereditary cancers. / Villella, Jeannine A.; Parmar, Madhu; Donohue, Kathleen; Fahey, Cathy; Piver, M. Steven; Rodabaugh, Kerry J.

In: Gynecologic Oncology, Vol. 102, No. 3, 01.09.2006, p. 475-479.

Research output: Contribution to journalArticle

Villella, Jeannine A. ; Parmar, Madhu ; Donohue, Kathleen ; Fahey, Cathy ; Piver, M. Steven ; Rodabaugh, Kerry J. / Role of prophylactic hysterectomy in patients at high risk for hereditary cancers. In: Gynecologic Oncology. 2006 ; Vol. 102, No. 3. pp. 475-479.
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abstract = "Background.: Current surgical recommendations for ovarian cancer prophylaxis in women at high risk of developing ovarian cancer include bilateral salpingo-oophorectomy (risk-reducing salpingo-oophorectomy (RRSO)). The role of hysterectomy is unclear. We sought to determine outcomes following prophylactic surgery in high-risk women. Methods.: We surveyed unaffected members of the Gilda Radner Familial Ovarian Cancer Registry who had undergone oophorectomy from 1981 to 2002. Data were collected and analyzed for statistical significance by the Fisher's Exact Test. Results.: Two hundred eighty women were surveyed, and 154 (55{\%}) responded; 97{\%} were Caucasian and 14{\%} reported being Jewish. The median age of the respondents was 51 years (range 29-79); median age at oophorectomy was 41 years (range 15-68). Fifty-eight patients (38{\%}) reported a laparoscopic procedure. One hundred five patients (68{\%}) had a simultaneous hysterectomy, and 4 (3{\%}) had a prior hysterectomy. Forty-four patients (29{\%}) underwent BSO only. Of these 44 patients, 40 (91{\%}) did not require a subsequent hysterectomy. Of the 4 who did, 2 were for leiomyomas, one for menorrhagia and the other was unknown. While not statistically significant, of the 3 patients who developed a subsequent gynecologic malignancy, all had undergone a hysterectomy. There was a statistically significant difference in whether or not the uterus was removed as part of the procedure by time period, whereby women treated prior to 1990 had a higher likelihood of having a hysterectomy (P = 0.03). Conclusion.: The women in our study did not require hysterectomy for prevention of malignancy. We conclude that one should screen for benign gynecological indications for hysterectomy when planning a prophylactic BSO for prevention of ovarian cancer. Other potential risk factors for endometrial cancer, including the role of UPSC in HBOC, remain to be elucidated.",
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