TY - JOUR
T1 - Pathologic findings at risk-reducing salpingo-oophorectomy
T2 - Primary results from Gynecologic Oncology Group trial GOG-0199
AU - Sherman, Mark E.
AU - Piedmonte, Marion
AU - Mai, Phuong L.
AU - Ioffe, Olga B.
AU - Ronnett, Brigitte M.
AU - Van Le, Linda
AU - Ivanov, Iouri
AU - Bell, Maria C.
AU - Blank, Stephanie V.
AU - Disilvestro, Paul
AU - Hamilton, Chad A.
AU - Tewari, Krishnansu S.
AU - Wakeley, Katie
AU - Kauff, Noah D.
AU - Yamada, S. Diane
AU - Rodriguez, Gustavo
AU - Skates, Steven J.
AU - Alberts, David S.
AU - Walker, Joan L.
AU - Minasian, Lori
AU - Lu, Karen
AU - Greene, Mark H.
N1 - Publisher Copyright:
© 2014 by American Society of Clinical Oncology.
PY - 2014/10/10
Y1 - 2014/10/10
N2 - Purpose: Risk-reducing salpingo-oophorectomy (RRSO) lowers mortality from ovarian/tubal and breast cancers among BRCA1/2 mutation carriers. Uncertainties persist regarding potential benefits of RRSO among high-risk noncarriers, optimal surgical age, and anatomic origin of clinically occult cancers detected at surgery. To address these topics, we analyzed surgical treatment arm results from Gynecologic Oncology Group Protocol-0199 (GOG-0199), the National Ovarian Cancer Prevention and Early Detection Study.Participants and Methods: This analysis included asymptomatic high-risk women age ≥ 30 years who elected RRSO at enrollment. Women provided risk factor data and underwent preoperative cancer antigen 125 (CA-125) serum testing and transvaginal ultrasound (TVU). RRSO specimens were processed according to a standardized tissue processing protocol and underwent central pathology panel review. Research-based BRCA1/2 mutation testing was performed when a participant's mutation status was unknown at enrollment. Relationships between participant characteristics and diagnostic findings were assessed using univariable statistics and multivariable logistic regression.Results: Invasive or intraepithelial ovarian/tubal/peritoneal neoplasms were detected in 25 (2.6%) of 966 RRSOs (BRCA1 mutation carriers, 4.6%; BRCA2 carriers, 3.5%; and noncarriers, 0.5%; P<.001) In multivariable models, positive BRCA1/2 mutation status (P =.0056), postmenopausal status (P =.0023), and abnormal CA-125 levels and/or TVU examinations (P>.001) were associated with detection of clinically occult neoplasms at RRSO. For 387 women with negative BRCA1/2 mutation testing and normal CA-125 levels, findings at RRSO were benign.Conclusion: Clinically occult cancer was detected among 2.6% of high-risk women undergoing RRSO BRCA1/2 mutation, postmenopausal status, and abnormal preoperative CA-125 and/or TVU were associated with cancer detection at RRSO. These data can inform management decisions among women at high risk of ovarian/tubal cancer.
AB - Purpose: Risk-reducing salpingo-oophorectomy (RRSO) lowers mortality from ovarian/tubal and breast cancers among BRCA1/2 mutation carriers. Uncertainties persist regarding potential benefits of RRSO among high-risk noncarriers, optimal surgical age, and anatomic origin of clinically occult cancers detected at surgery. To address these topics, we analyzed surgical treatment arm results from Gynecologic Oncology Group Protocol-0199 (GOG-0199), the National Ovarian Cancer Prevention and Early Detection Study.Participants and Methods: This analysis included asymptomatic high-risk women age ≥ 30 years who elected RRSO at enrollment. Women provided risk factor data and underwent preoperative cancer antigen 125 (CA-125) serum testing and transvaginal ultrasound (TVU). RRSO specimens were processed according to a standardized tissue processing protocol and underwent central pathology panel review. Research-based BRCA1/2 mutation testing was performed when a participant's mutation status was unknown at enrollment. Relationships between participant characteristics and diagnostic findings were assessed using univariable statistics and multivariable logistic regression.Results: Invasive or intraepithelial ovarian/tubal/peritoneal neoplasms were detected in 25 (2.6%) of 966 RRSOs (BRCA1 mutation carriers, 4.6%; BRCA2 carriers, 3.5%; and noncarriers, 0.5%; P<.001) In multivariable models, positive BRCA1/2 mutation status (P =.0056), postmenopausal status (P =.0023), and abnormal CA-125 levels and/or TVU examinations (P>.001) were associated with detection of clinically occult neoplasms at RRSO. For 387 women with negative BRCA1/2 mutation testing and normal CA-125 levels, findings at RRSO were benign.Conclusion: Clinically occult cancer was detected among 2.6% of high-risk women undergoing RRSO BRCA1/2 mutation, postmenopausal status, and abnormal preoperative CA-125 and/or TVU were associated with cancer detection at RRSO. These data can inform management decisions among women at high risk of ovarian/tubal cancer.
UR - https://www.scopus.com/pages/publications/84907484183
U2 - 10.1200/JCO.2013.54.1987
DO - 10.1200/JCO.2013.54.1987
M3 - Article
C2 - 25199754
AN - SCOPUS:84907484183
SN - 0732-183X
VL - 32
SP - 3275
EP - 3283
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 29
ER -