Optimization of Timing for Risk-Reducing Salpingectomy and Oophorectomy.
Kathryn P Pennington, Stephanie L Pugh, Warner Huh...
https://pubmed.ncbi.nlm.nih.gov/39509704/Actively Recruiting
Led by NRG Oncology · Updated on 2026-08-07
1956
Participants Needed
574
Research Sites
N/A
Total Duration
Researchers are studying two surgical procedures to reduce the risk of ovarian cancer in women with BRCA1 genetic mutations. This trial compares bilateral salpingectomy, which removes only the fallopian tubes, with bilateral salpingo-oophorectomy, which removes both fallopian tubes and ovaries. The goal is to find out if removing just the fallopian tubes with delayed ovary removal is nearly as effective as removing both from the start. Participants choose between two groups one undergoes bilateral salpingectomy with the option of later ovary removal, and the other undergoes bilateral salpingo-oophorectomy. Both groups have imaging tests like pelvic ultrasounds or pelvic MRIs during screening and provide blood samples throughout the study. Follow-up visits occur at multiple time points, including 10 to 60 days, 6 months, 12 months, 24 months, and then yearly for up to 20 years. During the study, researchers track if ovarian or related cancers develop and assess symptoms related to estrogen loss, quality of life, cancer-related distress, sexual function, menopausal symptoms, medical decision making, and any adverse events. Various questionnaires and imaging tests support these evaluations. Long-term safety and cancer risk reduction are monitored for up to two decades after surgery.
CONDITIONS
A Study to Compare Two Surgical Procedures in Individuals With BRCA1 Mutations to Assess Reduced Risk of Ovarian Cancer
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NRG Oncology
Lead Sponsor
National Cancer Institute (NCI)
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Bilateral Salpingectomy (Tube Removal) | Bilateral Salpingo-Oophorectomy (Ovary & Tube Removal) |
|---|---|---|
| What it is | A surgical procedure where both fallopian tubes are removed while the ovaries remain in place. Oophorectomy (removal of the ovaries) is delayed until later. This aims to reduce cancer risk while preserving ovarian function. | A surgical procedure that removes both fallopian tubes and both ovaries in one operation. This approach offers the strongest risk reduction for ovarian and related cancers in BRCA1 mutation carriers. |
| Role in the trial | Investigational arm: evaluates whether removing only the fallopian tubes and postponing oophorectomy maintains risk reduction for ovarian cancer while preserving natural hormone production. | Active comparator arm: established standard procedure for risk reduction in BRCA1 carriers; provides a basis for comparing cancer risk and quality of life. |
| Primary use or goal | To investigate if removing only both fallopian tubes, while delaying ovary removal, reduces the risk of developing ovarian, fallopian tube, or primary peritoneal cancer for women with BRCA1 mutations, while also preserving hormonal function. | To offer the established risk-reducing surgery for BRCA1 mutation carriers by removing both tubes and ovaries, lowering the risk of ovarian, fallopian tube, and peritoneal cancer as recommended by clinical guidelines. |
| How it is given or performed | Performed as a surgical procedure under anesthesia, one-time removal of both fallopian tubes. The ovaries are preserved and may be removed in a later surgery if needed or preferred. | Performed surgically, usually through a single operative session under anesthesia, to remove both ovaries and both fallopian tubes. Reproductive hormone production stops immediately after surgery. |
| Evidence status | No published long-term results yet from this approach in BRCA1 carriers. Ongoing clinical investigation is assessing whether salpingectomy alone provides comparable cancer risk reduction to the standard procedure. | Substantial evidence and guidelines show this procedure greatly reduces ovarian, fallopian tube, and peritoneal cancer risk for BRCA1 mutation carriers. |
| Important limitations | It is not yet proven whether the delayed oophorectomy strategy provides equivalent protection against ovarian and related cancers. Participants must eventually undergo a second surgery to remove the ovaries, and the long-term cancer risk with this staged approach is not established. | The procedure causes immediate, permanent menopause and loss of fertility, resulting in symptoms and long-term health effects; some women may not wish to undertake surgery that removes the ovaries at a younger age. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Pelvic ultrasound or MRI and blood tests within 180 days before registration
Duration - Single surgical event with follow-up
Participants undergo either bilateral salpingectomy with possible delayed oophorectomy or bilateral salpingo-oophorectomy as chosen. Blood samples are collected throughout the trial.
Initial surgery visit plus follow-up visits at 10-60 days, 6, 12, and 24 months
Duration - Up to 20 years
Participants are monitored yearly for up to 20 years to track cancer development, symptoms, quality of life, and adverse events.
Annual visits after 24 months post-surgery
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NON_RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
2
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Kathryn P Pennington, Stephanie L Pugh, Warner Huh...
https://pubmed.ncbi.nlm.nih.gov/39509704/NRG Oncology
Lead Sponsor
National Cancer Institute (NCI)
Collaborating Sponsor