To oophorectomy or not to oophorectomy: Practice patterns among urologists treating bladder cancer.

MedStar author(s):
Citation: Urologic Oncology. 36(3):90.e1-90.e7, 2018 03.PMID: 29273351Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Urogynecology | Urology | Urology; Literature and MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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]Year: 2018ISSN:
  • 1078-1439
Name of journal: Urologic oncologyAbstract: 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%).All authors: Carvahlo FL, Davis MF, Han CJ, Marchalik D, Richter LA, Stamatakis L, Sussman RD, Wethington SLOriginally published: Urologic Oncology. , 2017 Dec 19Fiscal year: FY2018Digital Object Identifier: Date added to catalog: 2018-01-18
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Journal Article MedStar Authors Catalog Article 29273351 Available 29273351

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%).

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