ArticleJournal of the National Cancer Institute2026
Menopause-related quality of life 5 years after salpingectomy with delayed oophorectomy vs salpingo-oophorectomy.
Article in Journal of the National Cancer Institute, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBRCA1/2 pathogenic variant (PV) carriers have an increased risk of tubo-ovarian cancer. They are recommended to have a risk-reducing salpingo-oophorectomy around age 40, resulting in premature menopause. The alternative risk-reducing salpingectomy (RRS) with delayed oophorectomy (DO) postpones this. We present the 5-year results of a nationwide preference trial (TUBA study) comparing menopause-related quality of life (QoL) after RRS/DO with salpingo-oophorectomy.
methodsPremenopausal BRCA1/2-PV carriers aged 25-40 (BRCA1) or 25-45 (BRCA2) chose RRS/DO or salpingo-oophorectomy with or without hormonal replacement therapy (HRT). We compared QoL (Greene Climacteric Scale) between RRS/DO and salpingo-oophorectomy without HRT 5 years after surgery using linear mixed models. Secondarily, RRS/DO was compared with salpingo-oophorectomy with HRT. Women who underwent oophorectomy in the RRS/DO group were excluded in a sensitivity analysis.
resultsIn total, 410 (71.9%) participants chose RRS/DO and 160 (28.1%) salpingo-oophorectomy. Seventy-three (17.8%) participants underwent oophorectomy within 5 years after salpingectomy. The adjusted mean difference (aMD) in QoL was 1.8 (95% CI = -0.6 to 4.3) after salpingo-oophorectomy without HRT and 1.4 (95% CI = -0.4 to 3.1) after salpingo-oophorectomy with HRT compared with RRS (with and without oophorectomy) at 5 years follow-up. The sensitivity analysis showed that QoL decreased less after RRS before oophorectomy compared with salpingo-oophorectomy without (aMD = 2.4, 95% CI = 0.1 to 4.8) and with HRT (aMD = 1.9, 95% CI = 0.1 to 3.7).
conclusionPostponing oophorectomy is key in preventing deterioration of QoL. QoL was similar 5 years after salpingectomy (with and without oophorectomy) compared with salpingo-oophorectomy (regardless of HRT use). However, QoL was higher when comparing salpingectomy without oophorectomy to salpingo-oophorectomy (regardless of HRT use).
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