Outcome of unexpected adnexal neoplasia discovered during risk reduction salpingo-oophorectomy in women with germ-line BRCA1 or BRCA2 mutations.

Autor: Conner JR; Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, USA., Meserve E; Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, USA., Pizer E; Cell-Netix, Seattle, USA., Garber J; Dana Farber/Brigham and Women's Cancer Center, Boston, MA, USA., Roh M; Department of Pathology, University of Michigan Medical School, Ann Arbor, USA., Urban N; Fred Hutchinson Cancer Research Center, Seattle, WA, USA., Drescher C; University of Washington School of Medicine, Seattle, WA, USA., Quade BJ; Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, USA., Muto M; Division of Gynecologic Pathology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA., Howitt BE; Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, USA., Pearlman MD; Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, USA., Berkowitz RS; Division of Gynecologic Pathology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA., Horowitz N; Division of Gynecologic Pathology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA., Crum CP; Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, USA. Electronic address: ccrum@partners.org., Feltmate C; Division of Gynecologic Pathology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2014 Feb; Vol. 132 (2), pp. 280-6. Date of Electronic Publication: 2013 Dec 12.
DOI: 10.1016/j.ygyno.2013.12.009
Abstrakt: Objective: This study computed the risk of clinically silent adnexal neoplasia in women with germ-line BRCA1 or BRCA2 mutations (BRCA(m+)) and determined recurrence risk.
Methods: We analyzed risk reduction salpingo-oophorectomies (RRSOs) from 349 BRCA(m+) women processed by the SEE-FIM protocol and addressed recurrence rates for 29 neoplasms from three institutions.
Results: Nineteen neoplasms (5.4%) were identified at one institution, 9.2% of BRCA1 and 3.4% of BRCA2 mutation-positive women. Fourteen had a high-grade tubal intraepithelial neoplasm (HGTIN, 74%). Mean age (54.4) was higher than the BRCA(m+) cohort without neoplasia (47.8) and frequency increased with age (p < 0.001). Twenty-nine BRCA(m+) patients with neoplasia from three institutions were followed for a median of 5 years (1-8 years.). One of 11 with HGTIN alone (9%) recurred at 4 years, in contrast to 3 of 18 with invasion or involvement of other sites (16.7%). All but two are currently alive. Among the 29 patients in the three institution cohort, mean ages for HGTIN and advanced disease were 49.2 and 57.7 (p = 0.027).
Conclusions: Adnexal neoplasia is present in 5-6% of RRSOs, is more common in women with BRCA1 mutations, and recurs in 9% of women with HGTIN alone. The lag in time from diagnosis of the HGTIN to pelvic recurrence (4 years) and differences in mean age between HGTIN and advanced disease (8.5 years) suggest an interval of several years from the onset of HGTIN until pelvic cancer develops. However, some neoplasms occur in the absence of HGTIN.
(Copyright © 2013 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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