Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
Clin Oncol (R Coll Radiol). 2018 Aug;30(8):463-471. doi: 10.1016/j.clon.2018.03.036. Epub 2018 Apr 22.
The optimal management of breast cancer susceptibility gene (BRCA)1/2 carriers with isolated serous tubal intraepithelial carcinoma (STIC) found at risk-reducing salpingo-oophorectomy (RRSO) is unclear. The prevalence of occult carcinoma and STIC in a consecutive series of BRCA1/2 carriers undergoing RRSO is reported. The outcome of staging procedures in BRCA1/2 carriers with isolated STIC at RRSO as well as the relationship between staging, chemotherapy treatment and risk of recurrence was assessed via a systematic review of the literature. Our series included 235 BRCA1/2 carriers who underwent RRSO. Federation of Gynaecology and Obstetrics stage IA carcinoma or STIC was found at RRSO in three (1.3%) and two (0.9%) patients, respectively. A systematic review of the literature included 82 BRCA1/2 carriers with isolated STIC found at RRSO. In 13/82 (16%) cases with STIC, staging was reported. In none of these cases staging revealed more advanced disease. Recurrent disease was found in four of 36 patients with reported follow-up. The estimated risk of recurrence in patients with isolated STIC at RRSO was about 11% (95% confidence interval 3-26%) after a median follow-up of 42 months (range 7-138). No recurrences were reported in those patients with STIC at RRSO who underwent staging or received chemotherapy. We found 1.3% occult carcinoma and 0.9% STIC at RRSO in our cohort of BRCA1/2 carriers. A systematic review of the literature suggests that additional treatment after RRSO, i.e. staging and/or chemotherapy, is associated with a lower risk of recurrence. However, data on staging and follow-up are limited.
在风险降低的输卵管卵巢切除术 (RRSO) 中发现的乳腺癌易感基因 (BRCA)1/2 携带者中孤立性浆液性输卵管内上皮内癌 (STIC) 的最佳管理尚不清楚。本文报道了一系列连续的 BRCA1/2 携带者在 RRSO 中发生隐匿性癌和 STIC 的患病率。通过对文献的系统回顾，评估了 BRCA1/2 携带者在 RRSO 中孤立性 STIC 进行分期程序的结果以及分期、化疗治疗与复发风险之间的关系。我们的系列研究包括 235 名接受 RRSO 的 BRCA1/2 携带者。在 RRSO 中，发现有 3 名（1.3%）和 2 名（0.9%）患者患有妇产科联合会分期 IA 期癌或 STIC。对文献的系统回顾包括 82 名在 RRSO 中发现孤立性 STIC 的 BRCA1/2 携带者。在 13/82（16%）有 STIC 的病例中，进行了分期。在这些病例中，没有分期显示出更晚期的疾病。在有报道的随访中，有 36 名患者中有 4 名出现复发疾病。在 RRSO 中孤立性 STIC 的患者，在中位数为 42 个月（范围 7-138）的随访后，复发风险估计约为 11%（95%置信区间 3-26%）。在 RRSO 中接受 STIC 分期或接受化疗的患者中，没有报告复发。我们在 BRCA1/2 携带者的队列中发现 RRSO 中有 1.3%的隐匿性癌和 0.9%的 STIC。对文献的系统回顾表明，RRSO 后进行额外的治疗，即分期和/或化疗，与降低复发风险相关。然而，关于分期和随访的数据有限。
