Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany; Department of Obstetrics and Gynecology, University Hospital, LMU, Munich, Germany.
Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany; Department of Obstetrics and Gynecology, University Hospital, LMU, Munich, Germany.
Gynecol Oncol. 2021 Dec;163(3):569-577. doi: 10.1016/j.ygyno.2021.09.004. Epub 2021 Sep 24.
We evaluated the clinical impact of germline (g)BRCA1/2-mutation on initial disease presentation, surgical implications, surgical morbidity and survival in patients with advanced epithelial ovarian cancer (EOC) undergoing debulking surgery (DS).
Data of all consecutive EOC patients with stage III/IV, high-grade serous disease and known gBRCA1/2 status (gBRCA; non-gBRCA), who underwent DS at our department between 01/2011 and 06/2019 were analyzed. Associations between gBRCA-status and severe postoperative complications and survival were analyzed.
gBRCA-status was determined in 50.1% (612/1221) of all patients. gBRCA was present in 21.9% (134/612). Significant differences were observed in terms of median age (p = 0.001) and histology (high-grade serous histology gBRCA: 98.5%, non-gBRCA 76.2%; p < 0.001). gBRCA-status had no impact on intraoperative disease presentation, surgical complexity or complete resection rate (gBRCA: 74.4%, non-gBRCA: 69.0%; p = 0.274). gBRCA-status was not predictive for severe postoperative complication (gBRCA: 12.0%, non-gBRCA: 19.1%; p = 0.082). Median PFS and OS was 31/22 and 71/53 months in patients with/without gBRCA-mutation, respectively. gBRCA was a significant prognostic factor for PFS (HR 0.57 p < 0.001) and for OS (HR 0.64, p = 0.048) after adjusting for established prognostic factors.
gBRCA-status had no impact on initial disease presentation, surgical results or postoperative complications. gBRCA patients have a significantly longer PFS but the impact on the long term prognosis is unclear. Complete resection remains the most important prognostic factor in patients with EOC independent of gBRCA-status.
我们评估了胚系（g）BRCA1/2 突变对接受肿瘤细胞减灭术（DS）的晚期上皮性卵巢癌（EOC）患者初始疾病表现、手术影响、手术发病率和生存的临床影响。
分析了 2011 年 1 月至 2019 年 6 月期间在我科接受 DS 的所有 III/IV 期、高级别浆液性疾病且已知 gBRCA1/2 状态（gBRCA；非 gBRCA）的连续 EOC 患者的数据。分析 gBRCA 状态与严重术后并发症和生存之间的关系。
在所有患者中，50.1%（612/1221）确定了 gBRCA 状态。gBRCA 存在于 21.9%（134/612）中。在中位年龄（p=0.001）和组织学（高级别浆液性组织学 gBRCA：98.5%，非 gBRCA：76.2%；p<0.001）方面观察到显著差异。gBRCA 状态对术中疾病表现、手术复杂性或完全切除率无影响（gBRCA：74.4%，非 gBRCA：69.0%；p=0.274）。gBRCA 状态不能预测严重的术后并发症（gBRCA：12.0%，非 gBRCA：19.1%；p=0.082）。有/无 gBRCA 突变的患者的中位 PFS 和 OS 分别为 31/22 和 71/53 个月。gBRCA 是 PFS（HR 0.57，p<0.001）和 OS（HR 0.64，p=0.048）的显著预后因素，调整了既定预后因素后。
gBRCA 状态对初始疾病表现、手术结果或术后并发症没有影响。gBRCA 患者的 PFS 明显更长，但对长期预后的影响尚不清楚。在 gBRCA 状态独立的 EOC 患者中，完全切除仍然是最重要的预后因素。
