Risk-reducing surgery for ovarian cancer: outcomes in 300 surgeries suggest a low peritoneal primary risk.
Risk-reducing salpingo-oophorectomy is currently advocated for the reduction of both breast and ovarian cancer risk in BRCA1/2 carriers, but residual risk of peritoneal primary cancer remains a concern. A sequential series of women attending a single institution for ovarian risk management underwent either risk-reducing surgery or screening. A person-years at risk analysis was used to compare observed versus expected cancers. In total, 300 women underwent risk-reducing salpingo-oophorectomy, including 160 BRCA1/2 mutation carriers. Three occult ovarian cancers were detected at surgery. There have been 2400.4 years of follow-up and 15.79 expected cancers. No peritoneal cancers have occurred. Amongst 503 women controls with 3444.3 years of follow-up, 15.93 ovarian cancers were expected and 17 were found. There were six ovarian cancer-related deaths in the control group compared with one in the surgery group. Risk-reducing salpingo-oophorectomy in a single institution has so far avoided peritoneal cancer incidence.
University of Manchester and Central Manchester and Manchester Children's University Hospitals NHS Trust, St Mary's Hospital, UK. Gareth.evans@cmmc.nhs.uk
D Gareth R
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Evans
Richard
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Clayton
Paul
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Donnai
Andrew
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Shenton
Fiona
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Lalloo
D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D019398:Genes, BRCA1; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006801:Humans; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy; D010534:Peritoneal Neoplasms / Q000453:epidemiology*; D012308:Risk Management