The following is a summary of “Long-term outcomes of hysterectomy with bilateral salpingo-oophorectomy: a systematic review and meta-analysis,” published in the January 2024 issue of Obstetrics and Gynecology by Hassan, et al.
For a study, researchers sought to conduct an updated systematic review and meta-analysis to evaluate the long-term outcomes associated with bilateral salpingo-oophorectomy performed at the time of hysterectomy.
The study updated a previous systematic review by searching PubMed, Web of Science, and Embase for relevant publications published between January 2015 and August 2022. Included studies involved women who underwent hysterectomy with bilateral salpingo-oophorectomy compared to those who underwent hysterectomy with ovarian conservation or no surgical intervention. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. Adjusted hazard ratios from eligible studies were extracted and synthesized using fixed-effect models to obtain pooled estimates.
Hysterectomy with bilateral salpingo-oophorectomy in young women was linked to a reduced risk of breast cancer (HR: 0.78; 95% CI: 0.73–0.84) but an elevated risk of colorectal cancer (HR: 1.27; 95% CI: 1.10–1.47). Additionally, it was associated with increased risks of total cardiovascular diseases, coronary heart disease, and stroke, with HRs of 1.18 (95% CI: 1.11–1.25), 1.17 (95% CI: 1.10–1.25), and 1.20 (95% CI: 1.10–1.31), respectively. Compared with no surgery, hysterectomy with bilateral salpingo-oophorectomy before age 50 was associated with higher risks of hyperlipidemia (HR: 1.44; 95% CI: 1.25–1.65), diabetes mellitus (HR: 1.16; 95% CI: 1.09–1.24), hypertension (HR: 1.13; 95% CI: 1.06–1.20), dementia (HR: 1.70; 95% CI: 1.07–2.69), and depression (HR: 1.39; 95% CI: 1.22–1.60). However, the evidence regarding the association with all-cause mortality in young women exhibited substantial heterogeneity between studies (I2=85%; P<0.01).
Hysterectomy with bilateral salpingo-oophorectomy was associated with multiple long-term outcomes, highlighting both benefits and risks. The decision to include bilateral salpingo-oophorectomy in hysterectomy should be carefully considered, weighing the potential benefits against the associated risks.