title: Survival in women with MMR mutations and ovarian cancer: a multicentre study in Lynch syndrome kindreds.
abstract: BACKGROUND
  Women with a germline mutation in one of the MMR genes MLH1, MSH2 or MSH6 reportedly have 4-12% lifetime risk of ovarian cancer, but there is limited knowledge on survival. Prophylactic bilateral salpingo-oophorectomy (PBSO) has been suggested for preventing this condition.
  
  
  OBJECTIVE
  The purpose of this retrospective multicentre study was to describe survival in carriers of pathogenic mutations in one of the MMR genes, and who had contracted ovarian cancer.
  
  
  METHODS
  Women who had ovarian cancer, and who tested positive for or were obligate carriers of an MMR mutation, were included from 11 European centres for hereditary cancer. Most women had not attended for gynaecological screening. Crude and disease specific survival was calculated by the Kaplan-Meier algorithm.
  
  
  RESULTS
  Among the 144 women included, 81.5% had FIGO stage 1 or 2 at diagnosis. 10 year ovarian cancer specific survival independent of staging was 80.6%, compared to less than 40% that is reported both in population based series and in BRCA mutation carriers. Disease specific 30 year survival for ovarian cancer was 71.5%, and for all hereditary non-polyposis colon cancer (HNPCC)/Lynch syndrome related cancers including ovarian cancer it was 47.3%.
  
  
  CONCLUSIONS
  In the series examined, infiltrating ovarian cancer in Lynch syndrome had a better prognosis than infiltrating ovarian cancer in BRCA1/2 mutation carriers or in the general population. Lifetime risk of ovarian cancer of about 10% and a risk of dying of ovarian cancer of 20% gave a lifetime risk of dying of ovarian cancer of about 2% in female MMR mutation carriers.
authors.affiliation: Section for Inherited Cancer, Department of Medical Genetics, Rikshospitalet-Radiumhospitalet Medical Center, Oslo N-0310, Norway.
authors.forename: Eli Marie
authors.initials: EM
authors.lastname: Grindedal
authors.forename: Laura
authors.initials: L
authors.lastname: Renkonen-Sinisalo
authors.forename: Hans
authors.initials: H
authors.lastname: Vasen
authors.forename: Gareth
authors.initials: G
authors.lastname: Evans
authors.forename: Paola
authors.initials: P
authors.lastname: Sala
authors.forename: Ignacio
authors.initials: I
authors.lastname: Blanco
authors.forename: Jacek
authors.initials: J
authors.lastname: Gronwald
authors.forename: Jaran
authors.initials: J
authors.lastname: Apold
authors.forename: Diana M
authors.initials: DM
authors.lastname: Eccles
authors.forename: Angel Alonso
authors.initials: AA
authors.lastname: Sánchez
authors.forename: Julian
authors.initials: J
authors.lastname: Sampson
authors.forename: Heikki J
authors.initials: HJ
authors.lastname: Järvinen
authors.forename: Lucio
authors.initials: L
authors.lastname: Bertario
authors.forename: Gillian C
authors.initials: GC
authors.lastname: Crawford
authors.forename: Astrid Tenden
authors.initials: AT
authors.lastname: Stormorken
authors.forename: Lovise
authors.initials: L
authors.lastname: Maehle
authors.forename: Pal
authors.initials: P
authors.lastname: Moller
mesh_terms: D048868:Adaptor Proteins, Signal Transducing / Q000235:genetics*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics*; D053843:DNA Mismatch Repair; D004268:DNA-Binding Proteins / Q000235:genetics*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D000070957:MutL Protein Homolog 1; D051718:MutS Homolog 2 Protein / Q000235:genetics*; D009154:Mutation; D009687:Nuclear Proteins / Q000235:genetics*; D010051:Ovarian Neoplasms / Q000235:genetics*; D012189:Retrospective Studies
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D004268:DNA-Binding Proteins; C094443:G-T mismatch-binding protein; C501486:MLH1 protein, human; D009687:Nuclear Proteins; C497172:MSH2 protein, human; D000070957:MutL Protein Homolog 1; D051718:MutS Homolog 2 Protein