Why the fallopian tube is most probably not the origin of serous carcinoma of the ovary?-Part 5-Salp

Based on the proposed theory that the origin of high grade serous ovarian cancer is in the fallopian tubes, several gynecologic oncology groups have proposed salpingectomy to prevent ovarian cancer. After all the evidence I presented and discussed in the previous four parts, how is possible that many gynecologic oncologists still believe that ovarian serous carcinoma can be prevented with bilateral salpingectomy? The answer is simple. Between 2006 and 2010, there were 30 publications supporting the origin of serous carcinoma of the ovary in the fallopian tube. Most of the 30 publications had a different first author but, they were from only two groups. These studies were published in pathology, oncology, gynecology, and research journals. The large number of studies would seem to confirm the theory of the origin in the fallopian tube. However, since these 30 studies are from the two groups that originally proposed the theory, this casts some doubt on its validity.

In 2015, Dr Crum's group, probably after they realized that STIC was not present in "most cases of ovarian cancer", as they had predicted, proposed a dualistic model of high grade serous carcinoma of ovary. Unfortunately, the number of papers supporting this change is not even close to the number of those proposing the fallopian tube origin.

Another interesting study, published by Dr. Falconer, of the Karolinska Institute, showed that salpingectomy cut the risk of ovarian cancer in half. But the same result was observed with hysterectomy, without salpingectomy.

Proposing a surgical procedure to prevent ovarian cancer without a complete understanding of how the tumors develop and how they disseminate in the abdominal cavity is difficult to understand. In addition, any new theory of the development of ovarian cancer should be able to explain why ovarian cancer is probably one of the few malignancies that even when it is resected at a smaller size than many years ago, is still found at high stage.