To oophorectomy or not to oophorectomy: Practice patterns among urologists treating bladder cancer.
To oophorectomy or not to oophorectomy: Practice patterns among urologists treating bladder cancer.
- 2018
CONCLUSIONS: Many urologic oncologists remain unaware of the benefits of risk-reducing salpingectomy and the risks associated with BSO, identifying a potential area for further education in the urologic community. Copyright (c) 2017 Elsevier Inc. All rights reserved. MATERIALS AND METHODS: An anonymous and voluntary electronic survey was distributed to members of the Society of Urologic Oncology (SUO). Demographic data, training, practice setting and duration, experience, rationale for BSO, and knowledge assessment of ovarian cancer pathogenesis/risks associated with BSO was collected. OBJECTIVES: Classically, radical cystectomy (RC) involves hysterectomy and bilateral salpingo-oophorectomy (BSO). Current understanding of ovarian cancer pathogenesis and effect of premature oophorectomy has lead to a shift within gynecology toward risk-reducing salpingectomy without oophorectomy in the absence of gynecologic malignancy. The purpose of this study was to assess knowledge base and practice patterns of urologic oncologists with regard to management of the gynecological organs at the time of RC. RESULTS: A total of 159/660 (24%) SUO members responded of whom 110 (69%) were academic urologists and 58 (36%) involved in training urologic oncology fellows. Of all, 75% had performed an ovarian-sparing RC. Furthermore, 14% were aware that salpingectomy alone reduces the risk of ovarian cancer, whereas 95%, 66%, and 26% were aware that BSO increases the risk of osteoporosis, cardiovascular disease, and all-cause mortality, respectively. Reasons for BSO at the time of RC included concern for urothelial carcinoma metastasis (54%), development of future gynecologic pathology (50%), and facilitation of pelvic lymph node dissection (36%).
English
1078-1439
10.1016/j.urolonc.2017.11.018 [doi] S1078-1439(17)30606-3 [pii]
*Cystectomy/sn [Statistics & Numerical Data]
*Ovariectomy/sn [Statistics & Numerical Data]
*Practice Patterns, Physicians'/sn [Statistics & Numerical Data]
*Salpingectomy/sn [Statistics & Numerical Data]
*Urinary Bladder Neoplasms/su [Surgery]
Adult
Aged
Clinical Competence
Cystectomy/ae [Adverse Effects]
Cystectomy/mt [Methods]
Female
Humans
Male
Medical Oncology/og [Organization & Administration]
Middle Aged
Neoplasms, Second Primary/ep [Epidemiology]
Neoplasms, Second Primary/pc [Prevention & Control]
Ovarian Neoplasms/ep [Epidemiology]
Ovarian Neoplasms/pc [Prevention & Control]
Ovariectomy/ae [Adverse Effects]
Ovariectomy/mt [Methods]
Salpingectomy/ae [Adverse Effects]
Salpingectomy/mt [Methods]
Surveys and Questionnaires
Urinary Bladder Neoplasms/pa [Pathology]
Urologists/sn [Statistics & Numerical Data]
Urology/og [Organization & Administration]
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Urogynecology
Urology
Urology; Literature and Medicine
Journal Article
CONCLUSIONS: Many urologic oncologists remain unaware of the benefits of risk-reducing salpingectomy and the risks associated with BSO, identifying a potential area for further education in the urologic community. Copyright (c) 2017 Elsevier Inc. All rights reserved. MATERIALS AND METHODS: An anonymous and voluntary electronic survey was distributed to members of the Society of Urologic Oncology (SUO). Demographic data, training, practice setting and duration, experience, rationale for BSO, and knowledge assessment of ovarian cancer pathogenesis/risks associated with BSO was collected. OBJECTIVES: Classically, radical cystectomy (RC) involves hysterectomy and bilateral salpingo-oophorectomy (BSO). Current understanding of ovarian cancer pathogenesis and effect of premature oophorectomy has lead to a shift within gynecology toward risk-reducing salpingectomy without oophorectomy in the absence of gynecologic malignancy. The purpose of this study was to assess knowledge base and practice patterns of urologic oncologists with regard to management of the gynecological organs at the time of RC. RESULTS: A total of 159/660 (24%) SUO members responded of whom 110 (69%) were academic urologists and 58 (36%) involved in training urologic oncology fellows. Of all, 75% had performed an ovarian-sparing RC. Furthermore, 14% were aware that salpingectomy alone reduces the risk of ovarian cancer, whereas 95%, 66%, and 26% were aware that BSO increases the risk of osteoporosis, cardiovascular disease, and all-cause mortality, respectively. Reasons for BSO at the time of RC included concern for urothelial carcinoma metastasis (54%), development of future gynecologic pathology (50%), and facilitation of pelvic lymph node dissection (36%).
English
1078-1439
10.1016/j.urolonc.2017.11.018 [doi] S1078-1439(17)30606-3 [pii]
*Cystectomy/sn [Statistics & Numerical Data]
*Ovariectomy/sn [Statistics & Numerical Data]
*Practice Patterns, Physicians'/sn [Statistics & Numerical Data]
*Salpingectomy/sn [Statistics & Numerical Data]
*Urinary Bladder Neoplasms/su [Surgery]
Adult
Aged
Clinical Competence
Cystectomy/ae [Adverse Effects]
Cystectomy/mt [Methods]
Female
Humans
Male
Medical Oncology/og [Organization & Administration]
Middle Aged
Neoplasms, Second Primary/ep [Epidemiology]
Neoplasms, Second Primary/pc [Prevention & Control]
Ovarian Neoplasms/ep [Epidemiology]
Ovarian Neoplasms/pc [Prevention & Control]
Ovariectomy/ae [Adverse Effects]
Ovariectomy/mt [Methods]
Salpingectomy/ae [Adverse Effects]
Salpingectomy/mt [Methods]
Surveys and Questionnaires
Urinary Bladder Neoplasms/pa [Pathology]
Urologists/sn [Statistics & Numerical Data]
Urology/og [Organization & Administration]
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Urogynecology
Urology
Urology; Literature and Medicine
Journal Article