Oestrogen receptor status determines oncological benefits of laparoscopic oophorectomy

A meta-analysis of over 3000 patients in 1992 demonstrated that ovarian abl ation in women less than 50 years of age produces a highly significant redu ction in both disease recurrence and mortality. Laparoscopic ovarian ablati on has been offered to premenopausal women at the University College Hospit al in Galway for 12 years. A review of 136 cases with follow-up and examina tion of disease-free survival and mortality is presented. The influence of oestrogen receptor status on response and long-term outcome is examined. Premenopausal women over the age of 40 years were offered bilateral laparos copic oophorectomy. This procedure was well tolerated with no serious morbi dity. A significant difference in disease-free survival and reduction in mo rtality was observed in the oestrogen receptor positive group when compared with women with oestrogen receptor negative disease. No significant differ ence in disease-free survival or mortality was observed between the oestrog en receptor negative group and a comparable control group. These results ha ve influenced our patient selection for this adjuvant treatment. A controll ed prospective trial is now necessary to examine the role of laparoscopic o ophorectomy in oestrogen receptor negative, premenopausal women with breast cancer. (C) 2001 Harcourt Publishers Ltd.