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Original research
Long-term outcomes following a diagnosis of ovarian cancer at the time of preventive oophorectomy among BRCA1 and BRCA2 mutation carriers
  1. Joanne Kotsopoulos1,2,
  2. Beth Karlan3,
  3. Jacek Gronwald4,
  4. Elizabeth Hall1,
  5. Pal Moller5,
  6. Nadine Tung6,
  7. Dana Zakalik7,
  8. William D Foulkes8,
  9. Barry Rosen9,
  10. Susan L Neuhausen10,
  11. Ping Sun1,
  12. Jan Lubinksi4 and
  13. Steven A Narod1,2
  1. 1Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
  2. 2Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  3. 3David Geffen School of Medicine, UCLA, Los Angeles, California, USA
  4. 4International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian, Pomeranian Medical University in Szczecin, Szczecin, Zachodniopomorskie, Poland
  5. 5Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
  6. 6Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  7. 7Beaumont Hospital, Royal Oak, Troy, Michigan, USA
  8. 8Program in Cancer Genetics, Department of Oncology and Human Genetics, McGill University, Montreal, Quebec, Canada
  9. 9Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
  10. 10Division of Biomarkers of Early Detection and Prevention, Department of Population Sciences, Beckman Research Institute City of Hope, Duarte, California, USA
  1. Correspondence to Dr Steven A Narod, Women's College Research Institute, Women's College Hospital, Toronto, ON M5S 1B2, Canada; steven.narod{at}wchospital.ca

Abstract

Introduction Preventive bilateral salpingo-oophorectomy is the most effective means of reducing the risk of ovarian cancer among women with an inherited BRCA1 or BRCA2 mutation. Some women are diagnosed with an invasive cancer (ovarian or fallopian tube) at the time of preventive surgery, referred to as an ‘occult’ cancer. The survival experience of these women is not known.

Methods We estimated the 10-year survival for 52 BRCA mutation carriers diagnosed with an occult ovarian or fallopian tube cancer at the time of preventive bilateral salpingo-oophorectomy.

Results The mean age at diagnosis was 51.6 (range 33–69) years. All were serous cancers (although 14 were missing information on histologic subtype). Of the 20 cases with information available on stage at diagnosis, 10 were stage I, 1 was stage II, and 9 were stage III (n=32 missing). After a mean of 6.8 years, 12 women died (23%). The 10-year all-cause survival was 74%.

Conclusion Although based on only 52 cases, these findings suggest a more favorable prognosis for BRCA mutation carriers diagnosed with an occult rather than incident disease.

  • ovariectomy
  • fallopian tube neoplasms
  • ovarian cancer

https://doi.org/10.1136/ijgc-2019-001141

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    Footnotes

    • Contributors Conceptualization: SAN, JK. Data analysis: PS, EH. Patient material/clinical information: all authors. Writing draft, review, and editing: all authors.

    • Funding Steven A Narod is the recipient of a Canada Research Chair (Tier I). Joanne Kotsopoulos is a recipient of a Tier II Canada Research Chair. This study was supported by a Canadian Cancer Society Research Institute Grant (703058) and the Peter Gilgan Centre for Women’s Cancers at Women’s College Hospital, in partnership with the Canadian Cancer Society.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. The data utilized in this analysis are from a longitudinal observational study of BRCA mutation carriers. Individuals requesting more information can contact the Principal Investigator (Steven A. Narod).