Opportunistic Salpingectomy for Prevention of Tubo-Ovarian Carcinoma

Importance The fallopian tube epithelium has been demonstrated to be an important source of tubo-ovarian carcinoma. Therefore, removal of the fallopian tubes during unrelated pelvic or abdominal surgery (opportunistic salpingectomy) can potentially lower future ovarian cancer risk. Objectives To assess current evidence on the efficacy, risks, and long-term outcomes of opportunistic salpingectomy and to develop consensus statements for the European Society of Gynaecological Oncology. Evidence Review An international working group of 14 individuals including a patient representative was formed to develop consensus statements on opportunistic salpingectomy. The MEDLINE database was used to conduct a literature review of English-language studies from January 1, 2000, through March 1, 2025, evaluating opportunistic salpingectomy for reduction of tubo-ovarian carcinoma, complication rates, additional surgical time, and impact on ovarian function. Statements were subsequently drafted collaboratively based on the review of the literature and adapted in an iterative process in conference call meetings with opportunity for anonymous and nonanonymous feedback. The anonymous voting was binary (agree/disagree) for each potential statement. Final statements reached consensus with more than 75% agreement. Findings In the literature review, 230 studies were identified, of which 129 were deemed relevant to consensus statement development. Consensus was achieved on 18 statements, with grades of recommendation ranging from B to D and levels of evidence from II to V. Opportunistic salpingectomy is significantly associated with a lower risk of subsequent tubo-ovarian carcinoma, with no adverse short-term impact on ovarian function. The procedure appears safe across surgical approaches, with little additional operative time. Existing evidence does not indicate harm to ovarian function or premature menopause, although long-term evidence is not available. Salpingectomy is feasible during both gynecological and nongynecological procedures and should be considered in women undergoing gynecological surgery and, where possible, in women undergoing selected nongynecological pelvic or abdominal surgeries. Conclusions and Relevance Existing evidence demonstrates that opportunistic salpingectomy is significantly associated with a lower risk of developing tubo-ovarian carcinoma. Clinicians should include this prevention intervention in preoperative counseling of eligible women.