Stroot, I.A.S. (Iris) (2021) Long-term clinical outcome of (pre)malignancy found during risk-reducing salpingo-oophorectomy in BRCA1/2 pathogenic variant carriers. thesis, Medicine.
Full text available on request.Abstract
Introduction: Carriers of a BRCA1 or BRCA2 pathogenic variant (PV) are at increased risk to develop ovarian cancer, which has a high mortality. Therefore, BRCA1/2 PV carriers are advised to undergo risk-reducing salpingo-oophorectomy (RRSO) before the incidence rises. High-grade serous carcinoma (HGSC) is the most diagnosed subtype of ovarian cancer in BRCA1/2 PV carriers, with serous tubal intra-epithelial carcinoma (STIC) presenting as a possible precursor of HGSC. HGSC or STIC may already be present in RRSO specimen, but the clinical relevance of these diagnosis at RRSO are unknown. In this study, we aim to determine the outcome and factors influencing survival of STIC and occult HGSC diagnosed at RRSO in BRCA1/2 PV carriers. Methods: Follow-up data was collected of eight women with STIC and 30 women with occult HGSC in RRSO specimen. Data was collected from the HEBON database, pathology reports and electronic patient files. Results: Mortality was 23.7% with a median follow-up time of 12.3 years per women and median age at RRSO of 57.7 years. Disease-free survival and overall survival were comparable between the women with STIC, early-stage and advanced stage HGSC. Mutation type, advanced stage HGSC, development of recurrence or platinum-resistance, RRSO at advanced age, use of OC and parity seemed to influence survival. Conclusion: Long-term outcome of women with STIC and occult HGSC at RRSO was relatively good. Difficult-to-treat HGSC, BRCA1 PV, delayed RRSO and a higher amount of ovulations negatively influenced survival. Chemotherapy for occult HGSC reduced the risk for recurrences, but did not influence survival. Further research is needed to find the optimal treatment for STIC and to unravel the factors negatively influencingsurvival of STIC and occult HGSC at RRSO.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Mourits, prof. dr. M.J.E. and Bock, prof. dr. G.H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jan 2022 09:45 |
| Last Modified: | 06 Jan 2022 09:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2968 |
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