6533b7d2fe1ef96bd125f596
RESEARCH PRODUCT
Uptake of hysterectomy and bilateral salpingo-oophorectomy in carriers of pathogenic mismatch repair variants:a Prospective Lynch Syndrome Database report
Einar Andreas RødlandJoan B. VidaHeike GörgensEivind HovigKirsi PylvänäinenMonika MorakWouter H. De Vos Tot Nederveen CappelLone SundeMark A. JenkinsLucio BertarioPatricia EsperonReinhard BüttnerFinlay A. MacraeFinlay A. MacraeInge BernsteinMarc S. GreenblattWolff SchmiegelGiulia Martina CavestroMaria Grazia TibilettiSilke RedlerZohreh KetabiKarl HeinimannFiona LallooHuw ThomasChristina TherkildsenDeepak VangalaMagnus Von Knebel DoeberitzMatilde NavarroErik RokkonesDouglas TjandraD. G. EvansMarta PinedaMarian J.e. MouritsLior H. KatzBernardo BonanniPablo KalfayanStephen N. ThibodeauLoic Le MarchandRevital KarivMaartje NielsenEmma J CrosbieOliver G. DentonStefanie HolzapfelGuy RosnerMev Dominguez-valentinJohn BurnVerena Steinke-langeCarlos A. VaccaroGabriela MösleinElke Holinski-federGabriel CapelláJohanna TecklenburgKarin WadtKate GreenChristoph EngelMiriam MintsAnna LepistöTamara Alejandra PiñeroJukka-pekka MecklinJohn L. HopperRobert HüneburgMarkus LoefflerFlorencia NeffaToni T. SeppäläClaudia PernePolly A. NewcombKarin AlvarezAdriana Della ValleJulian R. SampsonSanne W. Ten BroekeFrancisco Lopez-koestnerJohn-paul PlazzerJames HillHans Georg StraußIngrid WinshipIngrid WinshipNathan GluckNathan GluckAung Ko WinJane C. FigueiredoJürgen WeitzHans F. A. VasenRolf H. SijmonsWalter Hernán PavicicStefan AretzSteven GallingerNoralane M. LindorPål MøllerLaura Renkonen-sinisalosubject
0301 basic medicineCancer ResearchOophorectomyDatabases FactualColorectal cancerSURGERYmedicine.medical_treatmentCàncer d'ovaricomputer.software_genreDNA Mismatch Repair0302 clinical medicineEndometrial cancermunasarjasyöpäMedicineProspective StudiesColectomySalpingo-oophorectomy/methodsDatabaseManchester Cancer Research CentreCOLON-CANCERMLH1WOMENMiddle AgedPrognosisLynch syndrome3. Good healthkohdunrungon syöpäOncologyCOLECTOMY030220 oncology & carcinogenesisFemaleBiomarkers Tumor/geneticsAdultHeterozygoteGenital Neoplasms FemaleSalpingo-oophorectomyHysterectomy03 medical and health sciencesGenital Neoplasms Female/prevention & controlOvarian cancerColorectal Neoplasms Hereditary Nonpolyposis/geneticsBiomarkers TumorMortalitatHumansHysterectomy/methodsMortalityLynchin oireyhtymäRisk-reducing surgeryAgedHysterectomybusiness.industryEndometrial cancerResearchInstitutes_Networks_Beacons/mcrcCancerOophorectomyMSH63126 Surgery anesthesiology intensive care radiologymedicine.diseaseColorectal Neoplasms Hereditary NonpolyposisMSH2030104 developmental biologyCross-Sectional StudiesLynch syndromePMS2Càncer d'endometriMutationkohdunpoistobusinessOvarian cancercomputerFollow-Up Studiesdescription
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 30-69 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. (C) 2021 The Author(s). Published by Elsevier Ltd.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-05-01 |