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EP1070 Risk-reducing salpingo-oophorectomy in Brca mutation carriers. a prospective multicentric study
  1. V Del Vecchio1,
  2. V Loizzi1,
  3. E Cicinelli1,
  4. X Deromemaj1,
  5. A Kardhashi2,
  6. A Paradiso3,
  7. F Legge4,
  8. MI Natalicchio5,
  9. L Resta6,
  10. N Resta7 and
  11. G Cormio1,2
  1. 1Obstetrics and Gynecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari
  2. 2Gynecology Unit, IRCCS Istituto Tumori ‘Giovanni Paolo II’
  3. 3Institutional BioBank, Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori 'Giovanni Paolo II', Bari
  4. 4Obstetrics and Gynecology Unit, Regional General Hospital ‘F. Miulli’, Acquaviva delle Fonti
  5. 5Molecular Oncology and Pharmacogenomics Laboratory, University of Foggia, Foggia
  6. 6Department of Pathology, University of Bari
  7. 7Medical Genetics Unit, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy

Abstract

Introduction/Background Ovarian carcinoma is the leading cause of death among gynaecological malignancies, and there is a current lack of effective screening procedure. More than one-fifth of ovarian tumours have genetic predisposition and, in about 65–85% of these cases, the genetic abnormality is related to a germline mutation in Breast Related-Cancer Genes (BRCA) 1 and 2 which are tumour suppressor-autosomal dominant inherited genes encoding proteins involved in homologous recombination. Different studies evaluated the origin of early High Grade Serous Ovarian Cancer (HGSOC) in the distant portion of the fallopian tube and this discovery led to develop a risk-reducing strategy through a prophylactic bilateral salpingo-oophorectomy (BSO) in women with BRCA1/2 genes mutation.

Methodology Risk-reducing surgery (RRS) was performed in 74 patients carrying BRCA1 (aged between 34–73 years, median age was 50 years) and BRCA 2 mutation (aged between 41–69 years, median age was 52 years). 39 patients had previous history of breast cancer.

Results Between the 74 patients, 58 women (78,4%) underwent risk-reducing salpingo-oophorectomy (RRSO) through a laparoscopic minimally invasive approach, 5 (6,7%) underwent laparoscopic RRSO and contextual hysterectomy, 1 woman (1,4%) underwent RRSO through a laparotomic approach and 10 women (13,5%) laparotomic RRSO and hysterectomy. During 2 (2,7%) laparoscopic RRSO, prophylactic bilateral mastectomy was also performed. Early and late complication occurred in 3 patients (4%). 2 patients (2,7%) were found to have occult Serous Tubal Intraepithelial Carcinoma (STIC) and 3 patients (4%) occult cancer.

Conclusion RRSO is safe and feasible in BRCA mutation carriers. The procedure is effective for genetic prevention of ovarian cancer.

Disclosure Nothing to disclose

https://doi.org/10.1136/ijgc-2019-ESGO.1112

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