Routine Hysterectomy in the Surgical Management of Ovarian Cancer: A Retrospective Case Series, Physician Opinion Survey, and Review of the Literature

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Abstract

Current international guidelines recommend routine hysterectomy in the initial surgical management of epithelial ovarian cancer. However, there seems to be limited evidence to support these recommendations. We examined the data for a series of women undergoing hysterectomy as part of surgical management of ovarian cancer. Most of the women who underwent hysterectomy had no macroscopic uterine involvement in the ovarian cancer. However, almost half of them had macroscopic residual disease at completion of cytoreductive surgery. The incidence of synchronous primary endometrial cancers was 5%, and preoperative ultrasound had a sensitivity of 82% for predicting endometrial pathology. We also surveyed the members of the Australian Society of Gynaecological Oncologists (ASGO) regarding the role of hysterectomy in the management of ovarian cancer. Most of the respondents indicated that they believe hysterectomy should be routinely performed in the management of ovarian cancer but acknowledge that there is a lack of evidence to support the practice.

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