Article Text
Abstract
Introduction/Background Since most tubo-ovarian cancers originate in the fallopian tubes, the risk-reducing salpingectomy (RRS) with delayed oophorectomy (DO) was proposed as an alternative to risk-reducing salpingo-oophorectomy (RRSO). Compared to RRSO, menopause-related quality of life (QoL) appeared better after RRS up to one year post-surgery. We compare menopause-related QoL after RRS versus RRSO until three years post-surgery.
Methodology We performed a prospective multicenter preference study (TUBA study) among BRCA1/2 pathogenic variant (PV) carriers aged 25–40 (BRCA1) or 25–45 (BRCA2), who were premenopausal and without a future child wish. RRS could be performed from the age of 25 with DO at the maximum age of 45 (BRCA1) or 50 (BRCA2). RRSO could be performed between the ages of 35–40 (BRCA1) or 40–45 (BRCA2). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated.
Menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms.
Results Until April 2023, 410 participants had undergone RRS and 160 RRSO. The BRCA1/BRCA2 proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants three years after RRSO without HRT had a 4.3 (95% CI 2.1–6.5; p<.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (5.9–9.8) and 8.5 (6.5–10.5) points at three and twelve months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8–3.9; p0.002) point higher increase in GCS-score from baseline compared to the RRS group.
Conclusion Menopause-related QoL is better after RRS than after RRSO, even with HRT after RRSO. Differences between arms were most pronounced until one year post-surgery.
Disclosures None of the authors have anything to disclose.