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Meta-Analysis
. 2022 Jun 10;40(17):1879-1891.
doi: 10.1200/JCO.21.02016. Epub 2022 Mar 18.

Risk of Peritoneal Carcinomatosis After Risk-Reducing Salpingo-Oophorectomy: A Systematic Review and Individual Patient Data Meta-Analysis

Miranda P Steenbeek  1 , Majke H D van Bommel  1 , Johan Bulten  2 , Julia A Hulsmann  1 , Joep Bogaerts  2 , Christine Garcia  3 , Han T Cun  4 , Karen H Lu  4 , Heleen J van Beekhuizen  5 , Lucas Minig  6 , Katja N Gaarenstroom  7 , Marielle Nobbenhuis  8 , Mateja Krajc  9 , Vilius Rudaitis  10 , Barbara M Norquist  11 , Elizabeth M Swisher  11 , Marian J E Mourits  12 , Leon F A G Massuger  1 , Nicoline Hoogerbrugge  13 , Rosella P M G Hermens  14 , Joanna IntHout  15 , Joanne A de Hullu  1
Affiliations
Meta-Analysis

Risk of Peritoneal Carcinomatosis After Risk-Reducing Salpingo-Oophorectomy: A Systematic Review and Individual Patient Data Meta-Analysis

Miranda P Steenbeek et al. J Clin Oncol. .

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Methods: Unpublished data from three centers were supplemented by studies identified in a systematic review of EMBASE, MEDLINE, and the Cochrane library describing women with a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

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Conflict of interest statement

Marielle NobbenhuisConsulting or Advisory Role: Intuitive Surgical Mateja KrajcConsulting or Advisory Role: AstraZeneca, Pfizer Vilius RudaitisHonoraria: MedtronicConsulting or Advisory Role: AstraZeneca/MedImmuneResearch Funding: Inovio PharmaceuticalsTravel, Accommodations, Expenses: MSD Oncology, Roche, Karl Storz Elizabeth M. SwisherLeadership: IDEAYA BiosciencesNo other potential conflicts of interest were reported.

Figures

FIG 1.
FIG 1.
PRISMA IPD flow diagram to illustrate the study selection process. IPD, individual patient data; STIC, serous tubal intraepithelial carcinoma.
FIG 2.
FIG 2.
Kaplan-Meier plot to visualize the occurrence of peritoneal carcinomatosis after RRSO. RRSO, risk-reducing salpingo-oophorectomy, STIC, serous tubal intraepithelial carcinoma.
FIG 3.
FIG 3.
Predicted probability of PC after RRSO. PC, peritoneal carcinomatosis, RRSO, risk-reducing salpingo-oophorectomy, STIC serous tubal intraepithelial carcinoma.
FIG 4.
FIG 4.
Forest plot to visualize the two-stage analysis. HR, hazard ratio; PC, peritoneal carcinomatosis; STIC, serous tubal intraepithelial carcinoma.
See this image and copyright information in PMC

Comment in

References

    1. Siegel RL, Miller KD, Jemal A: Cancer statistics, 2019. CA Cancer J Clin 69:7-34, 2019 - PubMed
    1. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. : Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. Jama 317:2402-2416, 2017 - PubMed
    1. Oei AL, Massuger LF, Bulten J, et al. : Surveillance of women at high risk for hereditary ovarian cancer is inefficient. Br J Cancer 94:814-819, 2006 - PMC - PubMed
    1. Lu KH: Screening for ovarian cancer in asymptomatic women. JAMA 319:557-558, 2018 - PubMed
    1. Buys SS, Partridge E, Black A, et al. : Effect of screening on ovarian cancer mortality: The Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening randomized controlled trial. JAMA 305:2295-2303, 2011 - PubMed

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