Long-Term Health Consequences After Ovarian Removal at Benign Hysterectomy : A Nationwide Cohort Study.

Autor:	Gottschau M; Diet, Cancer and Health, Danish Cancer Society Research Center, Copenhagen, Denmark (M.G., J.H.V., L.M.)., Rosthøj S; Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark (S.R., G.L.A.)., Settnes A; Department of Obstetrics and Gynecology, North Zealand Hospital, University of Copenhagen, Hillerød, Denmark (A.S.)., Aalborg GL; Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark (S.R., G.L.A.)., Viuff JH; Diet, Cancer and Health, Danish Cancer Society Research Center, Copenhagen, Denmark (M.G., J.H.V., L.M.)., Munk C; Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (C.M.)., Jensen A; Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark (A.J.)., Kjær SK; Virus, Lifestyle and Genes, Danish Cancer Society Research Center, and Department of Gynecology, Rigshospitalet University Hospital, University of Copenhagen, Copenhagen, Denmark (S.K.K.)., Mellemkjær L; Diet, Cancer and Health, Danish Cancer Society Research Center, Copenhagen, Denmark (M.G., J.H.V., L.M.).
Jazyk:	angličtina
Zdroj:	Annals of internal medicine [Ann Intern Med] 2023 May; Vol. 176 (5), pp. 596-604. Date of Electronic Publication: 2023 Apr 18.
DOI:	10.7326/M22-1628
Abstrakt:	Background: More evidence is needed to substantiate current recommendations about removing ovaries during hysterectomy for benign conditions. Objective: To compare long-term outcomes in women with and without bilateral salpingo-oophorectomy (BSO) during hysterectomy for benign conditions. Design: Emulated target trial using data from a population-based cohort. Setting: Women in Denmark aged 20 years or older during 1977 to 2017. Participants: 142 985 women with hysterectomy for a benign condition, 22 974 with BSO and 120 011 without. Intervention: Benign hysterectomy with or without BSO. Measurements: The primary outcomes were overall hospitalization for cardiovascular disease (CVD), overall cancer incidence, and all-cause mortality through December 2018. Results: Compared with women without BSO, women with BSO who were younger than 45 years at surgery had a higher 10-year cumulative risk for hospitalization for CVD (risk difference [RD], 1.19 percentage points [95% CI, 0.09 to 2.43 percentage points]). Women with BSO had a higher 10-year cumulative risk for cancer for ages 45 to 54 years (RD, 0.73 percentage point [CI, 0.05 to 1.38 percentage points]), 55 to 64 years (RD, 1.92 percentage points [CI, 0.69 to 3.25 percentage points]), and 65 years or older (RD, 2.54 percentage points [CI, 0.91 to 4.25 percentage points]). Women with BSO had higher 10-year mortality in all age groups, although the differences were statistically significant only for ages 45 to 54 years (RD, 0.79 percentage point [CI, 0.27 to 1.30 percentage points]). The mortality at 20 years was inconsistent with that at 10 years in women aged 65 years or older. Limitation: Age was a proxy for menopausal status. Conclusion: The authors find that these results support current recommendations for conserving ovaries in premenopausal women without a high risk for ovarian cancer and suggest a cautious approach in postmenopausal women. Primary Funding Source: The Danish Cancer Society's Scientific Committee and the Mermaid Project. Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-1628.
Databáze:	MEDLINE
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