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卵巢癌幸存者行预防性双侧乳房切除术的作用?一项观察性研究。

Is There a Role for Risk-Reducing Bilateral Breast Surgery in Ovarian Cancer Survivors? An Observational Study.

机构信息

Medical Genetics Unit, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal.

University Clinic of Genetics, Faculdade de Medicina, Universidade de Coimbra, 3000-548 Coimbra, Portugal.

出版信息

Curr Oncol. 2023 Aug 23;30(9):7810-7817. doi: 10.3390/curroncol30090567.

Abstract

BACKGROUND

Risk-reducing surgeries are an option for cancer risk management in individuals. However, while adnexectomy is commonly recommended in breast cancer (BC) survivors, risk-reducing bilateral breast surgery (RRBBS) is controversial in ovarian cancer (OC) survivors due to relapse rates and mortality.

METHODS

We conducted a retrospective analysis of -OC survivors, with OC as first cancer diagnosis.

RESULTS

Median age at OC diagnosis for the 69 -OC survivors was 54 years. Median overall survival was 8 years, being significantly higher for patients than for patients ( = 0.011). Nine patients (13.2%) developed BC at a median age of 61 years. The mean overall BC-free survival was 15.5 years (median not reached). Eight patients (11.8%) underwent bilateral mastectomy (5 simultaneous with BC treatment; 3 RRBBS) at a median age of 56.5 years. The median time from OC to bilateral mastectomy/RRBBS was 5.5 years.

CONCLUSIONS

This study adds evidence regarding a lower BC risk after -OC and higher survival for -OC patients. A comprehensive analysis of the competing risks of OC mortality and recurrence against the risk of BC should be individually addressed. Surgical BC risk management may be considered for longer -OC disease-free survivors. Ultimately, these decisions should always be tailored to patients' characteristics and preferences.

摘要

背景

对于癌症风险管理,降低风险的手术是一种选择。然而,虽然在乳腺癌(BC)幸存者中普遍推荐附件切除术,但在卵巢癌(OC)幸存者中,降低风险的双侧乳房手术(RRBBS)存在争议,因为复发率和死亡率较高。

方法

我们对 69 名 OC 幸存者进行了回顾性分析,OC 为首次癌症诊断。

结果

69 名 OC 幸存者的中位 OC 诊断年龄为 54 岁。中位总生存期为 8 年,患者显著高于患者(=0.011)。9 名患者(13.2%)在中位年龄为 61 岁时诊断为 BC。总 BC 无复发生存的平均时间为 15.5 年(中位未达到)。8 名患者(11.8%)在中位年龄为 56.5 岁时接受了双侧乳房切除术(5 例与 BC 治疗同时进行;3 例 RRBBS)。从 OC 到双侧乳房切除术/RRBBS 的中位时间为 5.5 年。

结论

这项研究增加了 OC 后 BC 风险较低和 OC 患者生存率较高的证据。应单独分析 OC 死亡率和复发的竞争风险与 BC 风险,以做出综合分析。对于 OC 无病生存时间较长的患者,可能需要考虑进行 BC 的手术风险管理。最终,这些决策应始终根据患者的特征和偏好进行定制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fedc/10528403/62e48a99f7c2/curroncol-30-00567-g001.jpg

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