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  1. Vilius Rudaitis, MD*,,
  2. Tadas Zvirblis,
  3. Daiva Kanopiene, MD§,
  4. Dovile Janulynaite, MD*,
  5. Laimonas Griskevicius, MD, PhD*, and
  6. Ramunas Janavicius, MD, PhD,
  1. *Clinics of Internal, Family Medicine, and Oncology, Faculty of Medicine, Vilnius University;
  2. Department of Gynecology, Centre of Obstetrics and Gynecology, and
  3. Hematology, Oncology, and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos;
  4. §Vilnius University Institute of Oncology;
  5. Department of Molecular and Regenerative Medicine, Hematology, Oncology; and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos; and
  6. State Research Institute, Innovative Medicine Center, Vilnius, Lithuania.
  1. Address correspondence and reprint requests to Vilius Rudaitis, MD, Clinics of Internal, Family Medicine, and Oncology, Faculty of Medicine, Vilnius University, Ciurlionio St, 21, Vilnius, LT-08661, Lithuania. E-mail: vilius.rudaitis{at}santa.lt.

Abstract

Objective The aim of this study was to explore BRCA mutation frequency and to evaluate its impact on prognosis of advanced-stage ovarian cancer patients treated with debulking surgery and platinum-based chemotherapy.

Methods Patients with advanced-stage epithelial ovarian cancer were enrolled in a prospective, single-center study from September 2008 to December 2011. All cases were screened for BRCA1 and BRCA2 gene mutations. Progression-free survival (PFS) was assessed between BRCA1/2 mutation carriers and BRCA1/2 wild-type patients.

Results One hundred seven patients were enrolled and screened for BRCA1 and BRCA2 mutations; 51.4% patients were positive for BRCA1/2 gene mutation, 63.6% of which carried a single Baltic mutation, and 98.2% of them had serous histology. Older age (hazard ratio [HR], 1.032; 95% confidence interval [CI], 1.010–1.055; P = 0.0047), nonoptimal cytoreduction (HR, 3.170; 95% CI, 1.986–5.060; P < 0.0001), and BRCA1/2 wild type (HR, 1.625 [1.003–2.632]; P = 0.0486) were significantly associated with shorter PFS in multivariate Cox regression analysis. Only the nonoptimal cytoreduction was a statistically significant risk factor for shorter overall survival (HR, 2.684; 95% CI, 1.264–5.701; P= 0.0102).

Conclusions Advanced ovarian cancer patients harboring BRCA1/2 mutation treated with debulking surgery and platinum-based adjuvant chemotherapy have a longer PFS.

  • BRCA1
  • BRCA2
  • Cytoreductive surgery
  • Founder mutation

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Footnotes

  • The authors declare no conflicts of interest.

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