Risk of Peritoneal Carcinomatosis After Risk-Reducing Salpingo-Oophorectomy: A Systematic Review and Individual Patient Data Meta-Analysis

• Published in: Journal of clinical oncology Vol. 40; no. 17; pp. 1879 - 1891
• Main Authors: Steenbeek, Miranda P, van Bommel, Majke H D, Bulten, Johan, Hulsmann, Julia A, Bogaerts, Joep, Garcia, Christine, Cun, Han T, Lu, Karen H, van Beekhuizen, Heleen J, Minig, Lucas, Gaarenstroom, Katja N, Nobbenhuis, Marielle, Krajc, Mateja, Rudaitis, Vilius, Norquist, Barbara M, Swisher, Elizabeth M, Mourits, Marian J E, Massuger, Leon F A G, Hoogerbrugge, Nicoline, Hermens, Rosella P M G, IntHout, Joanna, de Hullu, Joanne A
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health 10.06.2022
• Subjects: Breast Neoplasms; Cystadenocarcinoma, Serous - pathology; Fallopian Tube Neoplasms - genetics; Fallopian Tube Neoplasms - prevention & control; Fallopian Tube Neoplasms - surgery; Female; Heterozygote; Humans; Mutation; ORIGINAL REPORTS; Ovarian Neoplasms - genetics; Ovarian Neoplasms - prevention & control; Ovariectomy - adverse effects; Peritoneal Neoplasms - genetics; Peritoneal Neoplasms - prevention & control; Salpingo-oophorectomy - adverse effects
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.21.02016

After risk-reducing salpingo-oophorectomy (RRSO), / pathogenic variant (PV) carriers have a residual risk to develop peritoneal carcinomatosis (PC). The etiology of PC is not yet clarified, but may be related to serous tubal intraepithelial carcinoma (STIC), the postulated origin for high-grade serous cancer. In this systematic review and individual patient data meta-analysis, we investigate the risk of PC in women with and without STIC at RRSO. Unpublished data from three centers were supplemented by studies identified in a systematic review of EMBASE, MEDLINE, and the Cochrane library describing women with a -PV with and without STIC at RRSO until September 2020. Primary outcome was the hazard ratio for the risk of PC between -PV carriers with and without STIC at RRSO, and the corresponding 5- and 10-year risks. Primary analysis was based on a one-stage Cox proportional-hazards regression with a frailty term for study. From 17 studies, individual patient data were available for 3,121 women, of whom 115 had a STIC at RRSO. The estimated hazard ratio to develop PC during follow-up in women with STIC was 33.9 (95% CI, 15.6 to 73.9), < .001) compared with women without STIC. For women with STIC, the five- and ten-year risks to develop PC were 10.5% (95% CI, 6.2 to 17.2) and 27.5% (95% CI, 15.6 to 43.9), respectively, whereas the corresponding risks were 0.3% (95% CI, 0.2 to 0.6) and 0.9% (95% CI, 0.6 to 1.4) for women without STIC at RRSO. -PV carriers with STIC at RRSO have a strongly increased risk to develop PC which increases over time, although current data are limited by small numbers of events.