Avtor/Urednik		Steenbeek, Miranda P.; Bommel, Majke H. D. van; Bulten, Johan; Bogaerts, Joep; Cun, Han T.; Lu, Karen H.; Beekhuizen, Heleen J van; Minig, Lucas; Gaarenstroom, Katja N.; Krajc, Mateja
Naslov		Risk of peritoneal carcinomatosis after risk-reducing salpingo-oophorectomy
Tip		članek
Vol. in št.		Letnik 40, št. 17
Leto izdaje		2022
Obseg		str. 1879-1891
ISSN		0732-183X - Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Jezik		eng
Abstrakt		After 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. Methods: Unpublished data from three centers were supplemented by studies identified in a systematic review of EMBASE, MEDLINE, and the Cochrane library describing women with a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. Results: From 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. Conclusion: BRCA-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.
Proste vsebinske oznake		peritonealna karcinimatoza ginekološki raki rak (bolezen) meta-analiza peritoneal carcinomatosis gynecological carcinomas cancer meta-analysis