OBJECTIVES

Increasing evidence suggests that the most common type of ovarian cancer originates in the fallopian tubes. Consequently, national gynecologist associations including U.S., U.K., and Australian societies published statements recommending prophylactic salpingectomy to prevent ovarian cancer. The German Society for Gynecology and Obstetrics has not yet recommended prophylactic salpingectomy due to lacking evidence. Aim of this study was to evaluate the trend of salpingectomies from 2005 to 2017 in Germany and compare it to trends in other pelvic surgeries.

METHODS

Data from the Federal Statistical Office on operations and procedures performed in German hospitals from 2005 until 2017 were used. The database contains the number of patients with full inpatient care by operation and procedure codes (OPS codes) in total and stratified by sex and age groups. The analysis was restricted to female patients. Pelvic surgeries were identified by OPS codes: salpingectomy alone (5-661), destruction and obstruction of uterine tubes [sterilization] (5-663), salpingo-oophorectomy (5-653), oophorectomy (5-652), and hysterectomy (5-683).

RESULTS

The number of fully inpatient female patients undergoing salpingectomy alone increased by +297% in 2017 compared to 2005. While the number remained steady from 2005 until 2011, it increased continuously afterwards. Other evaluated pelvic surgeries either showed a small growth (sterilization +59% and salpingo-oophorectomy +13%) or a decrease (oophorectomy -33% and hysterectomy -45%) from 2005 to 2017. All patients undergoing one of the pelvic surgeries were on average older in 2017 than in 2005 except for patients with a sterilization who tended to be younger in 2017. The proportion of total salpingectomies increased from 2006 (75%) to 2017 (87%) in contrast to partial salpingectomies (2006: 18%; 2017: 6%).

CONCLUSIONS

Although prophylactic salpingectomy is not recommended in German guidelines to prevent ovarian cancer, the number of salpingectomies has risen sharply since 2011 in Germany as in other countries with a recommendation.