American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the role of total abdominal hysterectomy and bilateral salpingo-oophorectomy for ovarian cancer treatment?

1. To treat all types of cancer

2. To reduce tumor size

3. To remove all cancerous tissue in early-stage disease

4. To improve fertility

The correct answer is: To remove all cancerous tissue in early-stage disease

Total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) play a critical role in the management of ovarian cancer, particularly in the context of early-stage disease. In cases where ovarian cancer is diagnosed at an early stage, surgical intervention is often the primary treatment modality aimed at achieving complete removal of cancerous tissues. This procedure involves the removal of the uterus, cervix, and both ovaries and fallopian tubes, which effectively eliminates the source of the cancer. By performing TAH-BSO, the surgical team aims not only to remove any visible tumors but also to minimize or eliminate the potential for cancer spread, thereby reducing the likelihood of recurrence. This complete surgical excision is crucial in early-stage diagnoses where the cancer may not have metastasized extensively, promoting better overall prognosis and outcomes for the patient. This approach contrasts with treating all types of cancer, which may involve varying treatment modalities depending on the specific cancer type and stage; reducing tumor size, which often necessitates neoadjuvant treatments rather than immediate surgical intervention; and improving fertility, as TAH-BSO results in loss of the ovaries and uterus, making it incompatible with fertility preservation. Thus, the goal of this surgical procedure in the context