image: The removal of the fallopian tube while preserving the ovary, as demonstrated by gynecological surgeon Ingo Runnebaum using a model (GPI Anatomicals, USA), is a preventive measure against ovarian cancer during planned abdominal surgeries in women who have completed their family planning.
Credit: Michael Szabó, Jena University Hospital (CC-BY 4.0, https://creativecommons.org/licenses/by/4.0/deed.en)
A mathematical modeling study conducted in Germany suggests that ovarian cancer incidence could be reduced and healthcare savings boosted if women who have already completed their families were offered fallopian tube removal during any other suitable abdominal surgeries. Angela Kather and Ingo Runnebaum of Jena University Hospital, Germany, and colleagues present these findings on January 30th in the open-access journal PLOS Medicine.
Some of the most widespread and serious forms of ovarian cancer begin in the fallopian tubes, and removing them may reduce ovarian cancer risk. While women at average risk of ovarian cancer are not recommended to have surgery solely to remove their fallopian tubes, many surgeons offer “opportunistic” tube removal during other gynecologic surgeries such as hysterectomy or tubal sterilization. Opportunistic removal may also be feasible during other abdominal surgeries, such as gallbladder removal.
However, the overall potential benefits of opportunistic fallopian tube removal have been unclear. To help clarify, Kather and colleagues developed a mathematical model that incorporates real-world patient statistics to predict population-level risks of ovarian cancer after opportunistic fallopian tube removal, as well as the potential healthcare cost savings.
By applying the model to statistics from Germany, the researchers predicted that opportunistic fallopian tube removal during every hysterectomy and tubal sterilization could reduce ovarian cancer cases by five percent across the female population of Germany. Removal during every suitable abdominal surgery for women who are done having children could reduce nationwide cancer cases by 15 percent, the analysis suggests, and it could save more than €10 million in healthcare costs annually.
Ovarian cancer is the third most common gynecologic cancer in the world and has a mortality rate of 66 percent. Overall, these findings suggest that opportunistic fallopian tube removal during appropriate abdominal surgeries could not only lower population-level ovarian cancer risks and prevent ovarian cancer deaths, but also provide economic benefits. This study could help inform health policy and insurance costs for the procedure.
The authors add, “We developed a mathematical model to estimate the likelihood of women undergoing surgeries that offer an opportunity for fallopian tube removal and the potential for reducing their ovarian cancer risk. Applying this model to the entire female population of Germany revealed that 15% of ovarian cancer cases could be prevented if fallopian tubes were removed during every suitable abdominal surgery in women who have completed their families. This approach has the potential to extend healthy years of life and significantly save healthcare costs.”
In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004514
Citation: Kather A, Arefian H, Schneider C, Hartmann M, Runnebaum IB (2025) Ovarian cancer prevention through opportunistic salpingectomy during abdominal surgeries: A cost-effectiveness modeling study. PLoS Med 22(1): e1004514. https://doi.org/10.1371/journal.pmed.1004514
Author countries: Germany
Funding: The author(s) received no specific funding for this work.
Journal
PLOS Medicine
Method of Research
Computational simulation/modeling
Subject of Research
Not applicable
COI Statement
Competing interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: IBR is a member of the Ovarian Tumor Committee of the German Gynecologic Oncology Group (AGO) and member of the writing committee responsible for releasing the ‘S3 Guideline on Diagnosis, Treatment, and Follow-up of Malignant Ovarian Tumors.’ The other authors declare no conflicts of interest.