Subsequent Oophorectomy and Ovarian Cancer after Hysterectomy for Benign Gynecologic Conditions at Chiang Mai University Hospital

  • Jitkunnatumkul, Aurapin (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University) ;
  • Tantipalakorn, Charuwan (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University) ;
  • Charoenkwan, Kittipat (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University) ;
  • Srisomboon, Jatupol (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University)
  • Published : 2016.08.01


This study was undertaken to determine the incidence of subsequent oophorectomy due to ovarian pathology or ovarian cancer in women with prior hysterectomy for benign gynecologic conditions at Chiang Mai University Hospital. Medical records of women who underwent hysterectomy for benign gynecologic diseases and precancerous lesions between January 1, 2004 and December 31, 2013 at Chiang Mai University Hospital were retrospectively reviewed. The incidence and indications of oophorectomy following hysterectomy were analyzed. During the study period, 1,035 women had hysterectomy for benign gynecologic conditions. Of these, 590 women underwent hysterectomy with bilateral salpingo-oophorectomy and 445 hysterectomy with bilateral ovarian preservation or unilateral salpingo-oophorectomy. The median age was 47 years (range, 11-75 years). Ten women (2.45 %) had subsequent oophorectomy for benign ovarian cysts. No case of ovarian cancer was found. The mean time interval between hysterectomy and subsequent oophorectomy was 43.1 months (range, 2-97 months) and the mean follow-up time for this patient cohort was 51 months (range, 1.3-124.9 months). According to our hospital-based data, the incidence of subsequent oophorectomy in women with prior hysterectomy for benign gynecologic conditions is low and all represent benign conditions.


  1. ACOG Practice Bulletin No. 89 (2008). Elective and riskreducing salpingo-oophorectomy. Obstet Gynecol, 111, 231-41.
  2. Asante A, Whiteman MK, Kulkarni A, et al (2010). Elective oophorectomy in the United States: trends and in-hospital complications, 1998-2006. Obstet Gynecol, 116, 1088-95.
  3. Casiano ER, Trabuco EC, Bharucha AE, et al (2013). Risk of oophorectomy after hysterectomy. Obstet Gynecol, 121, 1069-74.
  4. Chan JK, Urban R, Capra AM, et al (2014). Ovarian cancer rates after hysterectomy with and without salpingo-oophorectomy. Obstet Gynecol, 123, 65-72.
  5. Cibula D, Widschwendter M, Majek O (2011). Tubal ligation and the risk of ovarian cancer: review and meta-analysis. Hum Reprod Update, 17, 55-67.
  6. Dekel A, Efrat Z, Orvieto R, et al (1996). The residual ovary syndrome: a 20-year experience. Eur J Obstet Gynecol Reprod Biol, 68, 159-64.
  7. Ferlay J, Soerjomataram I, Dikshit R, et al (2012). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 136, 359-86.
  8. Greene MH, Mai PL, Schwartz PE (2013). Does bilateral salpingectomy with ovarian retention warrant consideration as a temporary bridge to risk-reducing bilateral oophorectomy in BRCA1/2 mutation carriers? Am J Obstet Gynecol, 204, 1-6.
  9. Jacoby VL, Grady D, Wactawski-Wende J, et al (2011). Oophorectomy vs ovarian conservation with hysterectomy: cardiovascular disease, hip fracture, and cancer in the Women's Health Initiative Observational Study. Arch Intern Med, 171, 760-8.
  10. Jansaka N, Suprasert P (2014). Survival outcomes of recurrent epithelial ovarian cancer: experience from a Thailand northern tertiary care center. Asian Pac J Cancer Prev, 15, 10837-40.
  11. Kontoravdis A, Kalogirou D, Antoniou G, et al (1996). Prophylactic oophorectomy in ovarian cancer prevention. Int J Gynaecol Obstet, 54, 257-62.
  12. Loft A, Lidegaard O, Tabor A (1997). Incidence of ovarian cancer after hysterectomy: a nationwide controlled follow up. Br J Obstet Gynaecol, 104, 1296-301.
  13. Moore MA, Attasara P, Khuhaprema T, et al (2008). Cancer epidemiology in mainland South-East Asia - past, present and future. Asian Pac J Cancer Prev, 11, 67-80.
  14. Morelli M, Venturella R, Mocciaro R, et al (2013). Prophylactic salpingectomy in premenopausal low-risk women for ovarian cancer: primum non nocere. Gynecol Oncol, 129, 448-51.
  15. Muto MG, Cramer DW, Brown DL, et al (1993). Screening for ovarian cancer: the preliminary experience of a familial ovarian cancer center. Gynecol Oncol, 51, 12-20.
  16. Naylor AC (1984). Hysterectomy--analysis of 2901 personally performed procedures. S Afr Med J, 65, 242-5.
  17. Parker WH, Broder MS, Liu Z, et al (2007). Ovarian conservation at the time of hysterectomy for benign disease. Clin Obstet Gynecol, 50, 354-61.
  18. Parker WH, Feskanich D, Broder MS, et al (2009). Long-term mortality associated with oophorectomy compared with ovarian conservation in the nurses' health study. Obstet Gynecol, 121, 709-16.
  19. Piver MS (1996). Prophylactic oophorectomy: reducing the U.S. death rate from epithelial ovarian cancer. A Continuing Debate. Oncologist, 1, 326-30.
  20. Plockinger B, Kolbl H (1994). Development of ovarian pathology after hysterectomy without oophorectomy. J Am Coll Surg, 178, 581-5.
  21. Rocca WA, Grossardt BR, de Andrade M, et al (2006). Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol, 7, 821-8.
  22. Rozario D, Brown I, Fung MF, et al (1997). Is incidental prophylactic oophorectomy an acceptable means to reduce the incidence of ovarian cancer? Am J Surg, 173, 495-8.
  23. Shuster LT, Gostout BS, Grossardt BR, et al (2008). Prophylactic oophorectomy in premenopausal women and long-term health. Menopause Int, 14, 111-6.
  24. Tantipalakorn C, Wanapirak C, Khunamornpong S, et al (2014). IOTA simple rules in differentiating between benign and malignant ovarian tumors. Asian Pac J Cancer Prev, 15, 5123-6.
  25. Whittemore AS, Harris R, Itnyre J (1992). Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. IV. The pathogenesis of epithelial ovarian cancer. collaborative ovarian cancer group. Am J Epidemiol, 136, 1212-20.
  26. Woodward ER, Sleightholme HV, Considine AM, et al (2007). Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective. BJOG, 114, 1500-9.
  27. Zalel Y, Lurie S, Beyth Y, et al (1997). Is it necessary to perform a prophylactic oophorectomy during hysterectomy? Eur J Obstet Gynecol Reprod Biol, 73, 67-70.