Why bilateral salpingo oophorectomy is done in stage 1A or 1B of endometrial cancer

NEET PG
#1

Why bilateral salpingo oophorectomy is done in stage 1A or 1B of endometrial cancer as in these stages only uterus is involved then why fallopian tubes and ovaries are also removed?

Bilateral salpingo-oophorectomy is the surgical removal of both fallopian tubes and ovaries. It is commonly performed in the management of endometrial cancer, even in early stages such as 1A or 1B. There are several reasons for this approach:

  1. Risk reduction: The fallopian tubes and ovaries are closely associated with the uterus and are potential sites for the spread of endometrial cancer cells. By removing these structures, the risk of cancer recurrence or spread to the ovaries or fallopian tubes is significantly reduced.
  2. Diagnostic accuracy: Removing the fallopian tubes and ovaries allows for thorough examination and staging of the disease. This helps in determining the extent of the cancer and provides important information for planning further treatment, such as the need for additional therapies like radiation or chemotherapy.
  3. Hormonal control: The ovaries are the primary source of estrogen and progesterone in premenopausal women. Since endometrial cancer is hormone-driven, removing the ovaries reduces the production of these hormones, which can help prevent cancer recurrence and control the disease.
  4. Surgical convenience: Performing a bilateral salpingo-oophorectomy during the initial surgery for endometrial cancer eliminates the need for additional surgeries in the future, should the cancer recur or spread to the ovaries or fallopian tubes. It streamlines the treatment process and reduces the overall burden on the patient.

However, it’s important to note that the decision to perform a bilateral salpingo-oophorectomy is individualized and based on several factors, including the patient’s age, desire for future fertility, overall health, and the specific characteristics of the tumor. The final decision is made by the patient in consultation with their healthcare provider, taking into consideration the potential benefits and risks of the procedure.