title: Clinical outcomes in patients with isolated serous tubal intraepithelial carcinoma (STIC): A comprehensive review.
abstract: OBJECTIVE. Serous tubal intraepithelial carcinoma (STIC) is currently considered the precursor lesion of pelvic (i.e., ovarian or peritoneal) high-grade serous carcinoma. The incidence of STIC has been reported to range from 0.6% to 7% in BRCA mutations carriers. However, the clinical outcome of patients with 'isolated' STIC remains elusive. The aim of this study is to review the published literature on isolated STIC to determine outcomes of these ients and present a summary of management strategies. METHODS. A systematic English-language literature search was conducted in PubMed, MEDLINE-Ovid, Scopus, EBSCO host, Cochrane Library of articles published from February 2006 to April 2015. Study inclusion criteria for review were the following: risk-reducing salpingo-oophorectomy (RRSO), BRCA mutation carriers, non-BRCA mutation carriers, and benign surgical indication. Exclusion criteria were as follows: the presence of synchronous gynecological cancers, concurrent non-gynecological malignancies, the presence of ovarian intraepithelial lesions, and articles that did not include any clinical information and were restricted to pathology information only. RESULTS. A total of 78 patients with isolated STIC were included in our analysis. The median age for all patients was 53.7 years (range; 37-83). Surgical indication was RRSO in 67 patients with BRCA mutations or high-risk personal or family history. In the other 11 patients, an incidental STIC was detected after surgery for non-cancerous indications. Eleven (16.4%) patients received chemotherapy after the diagnosis of STIC. The follow-up time ranged from 2 to 150 months. Three (4.5%) patients with BRCA mutations were diagnosed with primary peritoneal carcinoma (PPC) during the follow-up at 43, 48 and 72 months after RRSO. CONCLUSIONS. The rate of primary peritoneal carcinoma in patients with BRCA mutations and isolated STIC is 4.5%. The role of adjuvant therapy remains elusive and routine surveillance with tumor markers and imaging is not warranted.
authors.affiliation: Department of Gynecology, Hospital Italiano de San Justo Agustin Rocca, Buenos Aires, Argentina; Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Maria Guadalupe
authors.initials: MG
authors.lastname: Patrono
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Maria D
authors.initials: MD
authors.lastname: Iniesta
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Anais
authors.initials: A
authors.lastname: Malpica
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Karen H
authors.initials: KH
authors.lastname: Lu
authors.affiliation: Department of Gynecology, Hospital Clinico Universitario Virgen de la Arriaxa, Murcia, Spain.
authors.forename: Rodrigo Orozco
authors.initials: RO
authors.lastname: Fernandez
authors.affiliation: Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Gloria
authors.initials: G
authors.lastname: Salvo
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: peramire@mdanderson.org.
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000235:genetics; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000235:genetics / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005185:Fallopian Tube Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000628:therapy*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D015994:Incidence; D009154:Mutation; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000453:epidemiology* / Q000235:genetics / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000235:genetics; D010052:Ovariectomy; D017239:Paclitaxel / Q000008:administration & dosage; D017671:Platinum Compounds / Q000008:administration & dosage; D058994:Salpingectomy
chemical_list: D017671:Platinum Compounds; D017239:Paclitaxel
keywords: BRCA mutation; Risk reducing salpingo-oophorectomy; STIC; Serous intraepithelial carcinoma