Risk of Peritoneal Carcinomatosis After Risk-Reducing Salpingo-Oophorectomy: A Systematic Review and Individual Patient Data Meta-Analysis. Issue 17 (10th June 2022)

• Record Type: Journal Article
• Authors: Steenbeek, Miranda P.; van Bommel, Majke H.D.; Bulten, Johan; Hulsmann, Julia A.; Bogaerts, Joep; Garcia, Christine; Cun, Han T.; Lu, Karen H.; van Beekhuizen, Heleen J.; Minig, Lucas; Gaarenstroom, Katja N.; Nobbenhuis, Marielle; Krajc, Mateja; Rudaitis, Vilius; Norquist, Barbara M.; Swisher, Elizabeth M.; Mourits, Marian J.E.; Massuger, Leon F.A.G.; Hoogerbrugge, Nicoline; Hermens, Rosella P.M.G.; IntHout, Joanna; de Hullu, Joanne A.
• Is Part Of: Journal of clinical oncology. Volume 40:Issue 17(2022)
• Page Start: 1879
• Page End: 1891
• Publication Date: 2022-06-10
• Subjects: Oncology -- Periodicals; Cancer -- Periodicals; Oncology; Medical Oncology; Cancérologie -- Périodiques; Cancer -- Périodiques; Cancérologie; Cancer; Oncology; Oncologia; Càncer; Periodicals; 616.994
• DOI: 10.1200/JCO.21.02016
• Languages: English
• ISSNs: 0732-183X

Abstract

Abstract : PURPOSE: 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 METHODS: Unpublished data from three centers were supplemented by studies identified in a systematic review of EMBASE, MEDLINE, and the Cochrane library describing women with a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. Abstract :