A Proactive Approach to Ovarian Cancer: The New ESGO Consensus on Opportunistic Salpingectomy

Introduction and Context

For decades, ovarian cancer was thought to originate primarily within the ovaries themselves. However, a revolutionary shift in our understanding of gynecological oncology has identified the fallopian tube epithelium—specifically the distal end—as the primary site of origin for the majority of high-grade serous ovarian carcinomas (HGSOC). HGSOC is the most common and lethal form of the disease, often diagnosed at an advanced stage when prognosis is poor.

This paradigm shift has led to the concept of **opportunistic salpingectomy (OS)**: the removal of the fallopian tubes during a pelvic or abdominal surgery that is being performed for another reason (such as a hysterectomy, sterilization, or even non-gynecological procedures like gallbladder removal). By removing the tissue where the cancer starts, clinicians can theoretically prevent the disease before it ever reaches the ovaries. To standardize this practice, the European Society of Gynaecological Oncology (ESGO) recently convened an international working group to develop the 2026 Consensus Statements on Opportunistic Salpingectomy, providing a clear roadmap for clinicians worldwide.