Risk of Peritoneal Carcinomatosis after Risk-Reducing Salpingo-Oophorectomy: A Systematic Review and Individual Patient Data Meta-Analysis

Miranda P. Steenbeek*, Majke H.D. Van Bommel, Johan Bulten, Julia A. Hulsmann, Joep Bogaerts, Christine Garcia, Han T. Cun, Karen H. Lu, Heleen J. Van Beekhuizen, Lucas Minig, Katja N. Gaarenstroom, Marielle Nobbenhuis, Mateja Krajc, Vilius Rudaitis, Barbara M. Norquist, Elizabeth M. Swisher, Marian J.E. Mourits, Leon F.A.G. Massuger, Nicoline Hoogerbrugge, Rosella P.M.G. HermensJoanna Inthout, Joanne A. De Hullu

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

16 Citations (Scopus)


PURPOSEAfter risk-reducing salpingo-oophorectomy (RRSO), BRCA1/2 pathogenic variant (PV) carriers have a residual risk to develop peritoneal carcinomatosis (PC). The etiology of PC is not yet clarified, but may be related to serous tubal intraepithelial carcinoma (STIC), the postulated origin for high-grade serous cancer. In this systematic review and individual patient data meta-analysis, we investigate the risk of PC in women with and without STIC at RRSO.METHODSUnpublished data from three centers were supplemented by studies identified in a systematic review of EMBASE, MEDLINE, and the Cochrane library describing women with a BRCA-PV with and without STIC at RRSO until September 2020. Primary outcome was the hazard ratio for the risk of PC between BRCA-PV carriers with and without STIC at RRSO, and the corresponding 5- and 10-year risks. Primary analysis was based on a one-stage Cox proportional-hazards regression with a frailty term for study.RESULTSFrom 17 studies, individual patient data were available for 3,121 women, of whom 115 had a STIC at RRSO. The estimated hazard ratio to develop PC during follow-up in women with STIC was 33.9 (95% CI, 15.6 to 73.9), P <.001) compared with women without STIC. For women with STIC, the five- and ten-year risks to develop PC were 10.5% (95% CI, 6.2 to 17.2) and 27.5% (95% CI, 15.6 to 43.9), respectively, whereas the corresponding risks were 0.3% (95% CI, 0.2 to 0.6) and 0.9% (95% CI, 0.6 to 1.4) for women without STIC at RRSO.CONCLUSIONBRCA-PV carriers with STIC at RRSO have a strongly increased risk to develop PC which increases over time, although current data are limited by small numbers of events.

Original languageEnglish
Pages (from-to)1879-1891
Number of pages13
JournalJournal of Clinical Oncology
Issue number17
Early online date18 Mar 2022
Publication statusPublished - 10 Jun 2022

Bibliographical note

Funding Information:
Supported in part (Lithuania) by the Research Council of Lithuania grant P-MIP-22-187 (V.R.). No other authors received financial support for this study.

Publisher Copyright: © American Society of Clinical Oncology.


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