Surgical complications of salpingo-oophorectomy in women undergoing risk-reducing surgery for hereditary breast and ovarian cancer - A retrospective cohort study

OBJECTIVE: Risk-reducing bilateral salpingooophorectomy (RRSO) lowers the risk of ovarian cancer (OC) by 80-90% in women with a hereditary predisposition to breast and/or ovarian cancer (HBOC/HOC). As genetic testing expands, more women may be candidates for RRSO, which underscores the need to assess the safety of the procedure. We aimed to evaluate the frequency of surgical complications following RRSO to support informed decision-making for women advised to undergo the procedure.

DESIGN: Retrospective cohort study SETTING: Copenhagen University Hospital Herlev, Denmark January 2017-December 2022 PARTICIPANTS: 246 women with HBOC/HOC who underwent risk reducing surgery were included. Patients, who had declined to participate in quality assurance studies were excluded.

INTERVENTIONS: Risk reducing bilateral/unilateral salpingoophorectomy ± hysterectomy RESULTS: 246 women underwent surgery, and 15 (6.09%) experienced complications. 9 (60%) were Clavien Dindo grade I and 6 (40%) grade II. No grade III, IV, or V complications occurred. Grade I included minor pain or superficial infection not requiring antibiotic treatment, and grade II were all due to infections requiring treatment with antibiotics. No significant differences were found between women with and without complications with respect to age, BMI, previous abdominal surgery or smoking CONCLUSION: The incidence and severity of complications after risk reducing surgery were low. This evidence is valuable in counseling women with HBOC and offers reassurance about the safety of RRSO.