Abstract

Ovarian cancer has the highest mortality rate out of all types of gynecologic cancer. To date, all attempted ovarian cancer screening strategies have failed, probably because this disease represents different kinds of cancers. High-Grade Serous Cancer is considered the most frequently diagnosed, aggressive, genetically instable and often cause disseminated kind of disease. One of the important finding in last decade of gynecologic oncology is the confirmed theory that high grade tumors derive from the epithelium of the fallopian tube. These observations were mainly collected from women that carry BRCA1/2 mutations and underwent prophylactic salpingo-oophorectomy, in which most of the incidentally diagnosed in situ carcinomas or intraepithelial precursors of cancers (STIC) were detected not in the ovary but in the fimbrial end of the fallopian tube. In the general population, prophylactic salpingectomy might reduce the risk of sporadic ovarian cancer reducing at the same time the risk of premature death due to cardiovascular disease seen in women subjected to salpingo-oophorectomy before the onset of natural menopause. Bilateral salpingectomy with ovarian preservation should be considered as a preventive strategy for women with low risk of ovarian cancer (not carrying BRCA mutations).