TY - JOUR
T1 - Risk of Peritoneal Carcinomatosis after Risk-Reducing Salpingo-Oophorectomy
T2 - A Systematic Review and Individual Patient Data Meta-Analysis
AU - Steenbeek, Miranda P.
AU - Van Bommel, Majke H.D.
AU - Bulten, Johan
AU - Hulsmann, Julia A.
AU - Bogaerts, Joep
AU - Garcia, Christine
AU - Cun, Han T.
AU - Lu, Karen H.
AU - Van Beekhuizen, Heleen J.
AU - Minig, Lucas
AU - Gaarenstroom, Katja N.
AU - Nobbenhuis, Marielle
AU - Krajc, Mateja
AU - Rudaitis, Vilius
AU - Norquist, Barbara M.
AU - Swisher, Elizabeth M.
AU - Mourits, Marian J.E.
AU - Massuger, Leon F.A.G.
AU - Hoogerbrugge, Nicoline
AU - Hermens, Rosella P.M.G.
AU - Inthout, Joanna
AU - De Hullu, Joanne A.
N1 - 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.
PY - 2022/6/10
Y1 - 2022/6/10
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85131770845&partnerID=8YFLogxK
U2 - 10.1200/JCO.21.02016
DO - 10.1200/JCO.21.02016
M3 - Article
C2 - 35302882
AN - SCOPUS:85131770845
SN - 0732-183X
VL - 40
SP - 1879
EP - 1891
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 17
ER -
