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Title: Uptake of hysterectomy and bilateral salpingo-oophorectomy in carriers of pathogenic mismatch repair variants: a Prospective Lynch Syndrome Database report
Author: Seppälä, Toni T.
Domínguez Valentín, Mev
Crosbie, Emma J.
Engel, Christoph
Aretz, Stefan
Macrae, Finlay
Winship, Ingrid
Capellá, G. (Gabriel)
Thomas, Huw
Hovig, Eivind
Nielsen, Maartje
Sijmons, Rolf H.
Bertario, Lucio
Bonanni, Bernardo
Tibiletti, Maria G.
Cavestro, Giulia M.
Mints, Miriam
Gluck, Nathan
Katz, Lior
Heinimann, Karl
Vaccaro, Carlos A.
Green, Kate
Lalloo, Fiona
Hill, James
Schmiegel, Wolff
Vangala, Deepak
Perne, Claudia
Strauß, Hans Georg
Tecklenburg, Johanna
Holinski Feder, Elke
Steinke Lange, Verena
Mecklin, Jukka Pekka
Plazzer, John Paul
Pineda Riu, Marta
Navarro García, Matilde
Vida, Joan B.
Kariv, Revital
Rosner, Guy
Piñero, Tamara A.
Pavicic, Walter
Kalfayan, Pablo
Ten Broeke, Sanne W.
Jenkins, Mark A.
Sunde, Lone
Bernstein, Inge
Burn, John
Greenblatt, Marc
De Vos Tot Nederveen Cappel, Wouter H.
Della Valle, Adriana
Lopez Koestner, Francisco
Alvarez, Karin
Büttner, Reinhard
Görgens, Heike
Morak, Monika
Holzapfel, Stefanie
Hüneburg, Robert
Von Knebel Doeberitz, Magnus
Loeffler, Markus
Redler, Silke
Weitz, Jürgen
Pylvänäinen, Kirsi
Renkonen Sinisalo, Laura
Lepistö, Anna
Hopper, John L.
Win, Aung K.
Lindor, Noralane M.
Gallinger, Steven
Le Marchand, Loïc
Newcomb, Polly A.
Figueiredo, Jane C.
Thibodeau, Stephen N.
Therkildsen, Christina
Wadt, Karin A.W.
Mourits, Marian J.E.
Ketabi, Zohreh
Denton, Oliver G.
Rødland, Einar A.
Vasen, Hans
Neffa, Florencia
Esperon, Patricia
Tjandra, Douglas
Möslein, Gabriela
Sampson, Julian R.
Rokkones, Erik
Evans, D.G.
Møller, Pål
Keywords: Càncer d'ovari
Càncer d'endometri
Ovarian cancer
Endometrial cancer
Issue Date: 17-Mar-2021
Publisher: Elsevier B.V.
Abstract: Purpose: This study aimed to report the uptake of hysterectomy and/or bilateral salpingo-oophorectomy (BSO) to prevent gynaecological cancers (risk-reducing surgery [RRS]) in carriers of pathogenic MMR (path_MMR) variants. Methods: The Prospective Lynch Syndrome Database (PLSD) was used to investigate RRS by a cross-sectional study in 2292 female path_MMR carriers aged 30e69 years. Results: Overall, 144, 79, and 517 carriers underwent risk-reducing hysterectomy, BSO, or both combined, respectively. Two-thirds of procedures before 50 years of age were combined hysterectomy and BSO, and 81% of all procedures included BSO. Risk-reducing hysterectomy was performed before age 50 years in 28%, 25%, 15%, and 9%, and BSO in 26%, 25%, 14% and 13% of path_MLH1, path_MSH2, path_MSH6, and path_PMS2 carriers, respectively. Before 50 years of age, 107 of 188 (57%) BSO and 126 of 204 (62%) hysterectomies were performed in women without any prior cancer, and only 5% (20/392) were performed simultaneously with colorectal cancer (CRC) surgery. Conclusion: Uptake of RRS before 50 years of age was low, and RRS was rarely undertaken in association with surgical treatment of CRC. Uptake of RRS aligned poorly with gene- and age-associated risk estimates for endometrial or ovarian cancer that were published recently from PLSD and did not correspond well with current clinical guidelines. The reasons should be clarified. Decision-making on opting for or against RRS and its timing should be better aligned with predicted risk and mortality for endometrial and ovarian cancer in Lynch syn- drome to improve outcomes.
Note: Reproducció del document publicat a:
It is part of: European Journal of Cancer, 2021, vol. 148, p. 124-133
Related resource:
ISSN: 0959-8049
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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