Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
BJOG. 2023 Jul;130(8):968-977. doi: 10.1111/1471-0528.17415. Epub 2023 Feb 19.
To examine the effect of a premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer on objective and subjective cognition at least 10 years after RRSO.
A cross-sectional study with prospective follow-up, nested in a nationwide cohort.
Multicentre in the Netherlands.
641 women (66% BRCA1/2 pathogenic variant carriers) who underwent either a premenopausal RRSO ≤ age 45 (n = 436) or a postmenopausal RRSO ≥ age 54 (n = 205). All participants were older than 55 years at recruitment.
Participants completed an online cognitive test battery and a questionnaire on subjective cognition. We used multivariable regression analyses, adjusting for age, education, breast cancer, hormone replacement therapy, cardiovascular risk factors and depression.
The influence of RRSO on objective and subjective cognition of women with a premenopausal RRSO compared with women with a postmenopausal RRSO.
After adjustment, women with a premenopausal RRSO (mean time since RRSO 18.2 years) performed similarly on objective cognitive tests compared with women with a postmenopausal RRSO (mean time since RRSO 11.9 years). However, they more frequently reported problems with reasoning (odds ratio [OR] 1.8, 95% confidence interval [95% CI] 1.1-3.1) and multitasking (OR 1.9, 95% CI 1.1-3.4) than women with a postmenopausal RRSO. This difference between groups disappeared in an analysis restricted to women of comparable ages (60-70 years).
Reassuringly, approximately 18 years after RRSO, we found no association between premenopausal RRSO and objective cognition.
探讨绝经前降低风险的输卵管卵巢切除术（RRSO）对卵巢癌高危女性的影响，至少在 RRSO 后 10 年评估 RRSO 对客观和主观认知的影响。
前瞻性随访的病例对照研究，嵌套在全国性队列中。
荷兰多中心。
641 名女性（66%为 BRCA1/2 致病性变异携带者），其中 436 名接受了绝经前 RRSO（≤45 岁），205 名接受了绝经后 RRSO（≥54 岁）。所有参与者在招募时年龄均大于 55 岁。
参与者完成了在线认知测试和主观认知问卷。我们使用多变量回归分析，调整了年龄、教育、乳腺癌、激素替代疗法、心血管危险因素和抑郁等因素。
绝经前 RRSO 对绝经前 RRSO 女性与绝经后 RRSO 女性的客观和主观认知的影响。
调整后，绝经前 RRSO（RRSO 后平均时间 18.2 年）的女性在客观认知测试中的表现与绝经后 RRSO（RRSO 后平均时间 11.9 年）的女性相似。然而，与绝经后 RRSO 的女性相比，她们更频繁地报告在推理（优势比 [OR] 1.8，95%置信区间 [95%CI] 1.1-3.1）和多任务处理（OR 1.9，95%CI 1.1-3.4）方面存在问题。在将年龄（60-70 岁）相近的女性进行分析后，两组之间的这种差异消失了。
令人安心的是，在 RRSO 后大约 18 年，我们没有发现 RRSO 与客观认知之间存在关联。
