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RESEARCH PRODUCT
Risk-reducing hysterectomy and bilateral salpingo-oophorectomy in female heterozygotes of pathogenic mismatch repair variants: a Prospective Lynch Syndrome Database report
Eivind HovigBernardo BonanniMonika MorakMark A. JenkinsPatricia EsperonToni T. SeppäläToni T. SeppäläLone SundeLone SundePablo KalfayanGabriel CapelláInge BernsteinMatilde NavarroMarc S. GreenblattJohn BurnZohreh KetabiJohanna TecklenburgFrancisco Lopez-koestnerMiriam MintsHeike GörgensNeil A J RyanKate GreenAnnika AuranenDouglas TjandraDouglas TjandraRobert W. HaileMarta PinedaTamara Alejandra PiñeroStefan AretzStefan AretzRobert HüneburgVerena Steinke-langeMarkus LoefflerChristina TherkildsenJohn L. HopperDeepak VangalaHuw ThomasReinhard BüttnerJames HillEinar Andreas RødlandRevital KarivMaria Grazia TibilettiSigve NakkenStefanie HolzapfelD. Gareth EvansD. Gareth EvansOliver G. DentonJulian R. SampsonHenrik OkkelsJoan VidalLoic Le MarchandHans Georg StraußGabriela MösleinClaudia PerneClaudia PerneIngrid WinshipIngrid WinshipNathan GluckJane C. FigueiredoMev Dominguez-valentinWolff SchmiegelKarl HeinimannKirsi PylvänäinenKarin AlvarezMaartje NielsenWouter H. De Vos Tot Nederveen CappelFiona LallooAung Ko WinGuy RosnerCarlos A. VaccaroPolly A. NewcombElke Holinski-federJohn-paul PlazzerLior H. KatzChristoph EngelAnna LepistöJukka-pekka MecklinGiulia Martina CavestroAdriana Della ValleFinlay A. MacraeFinlay A. MacraeSanne W. Ten BroekeFlorencia NeffaRolf H. SijmonsMaría Laura GonzalezNils RahnerJürgen WeitzHans F. A. VasenStephen N. ThibodeauEmma J CrosbieLucio BertarioSteven GallingerNoralane M. LindorPål MøllerLaura Renkonen-sinisaloMagnus Von Knebel DoeberitzMagnus Von Knebel Doeberitzsubject
0301 basic medicinemedicine.medical_treatmentDNA Mismatch RepairGynecologic surgery0302 clinical medicineMalalties hereditàriesProspective StudiesProspective cohort studyGenetics (clinical)Mismatch Repair Endonuclease PMS2Incidence (epidemiology)Middle Aged16. Peace & justiceLynch syndrome3. Good health030220 oncology & carcinogenesisFemalesyöpätauditMutL Protein Homolog 1Genetic diseasesHeterozygotemedicine.medical_specialtySalpingo-oophorectomyCirurgia ginecològicaHysterectomyArticle03 medical and health sciencesCàncer colorectalCAPP2medicineHumansLynchin oireyhtymäGynecologyperinnölliset tauditHysterectomyHEREDITARY COLORECTAL-CANCERbusiness.industryEndometrial cancerCancermedicine.diseaseColorectal Neoplasms Hereditary NonpolyposisColorectal cancerASPIRIN030104 developmental biologyClinical researchLynch syndrome3121 General medicine internal medicine and other clinical medicinekohdunpoisto3111 BiomedicineOvarian cancerbusinessdescription
Abstract Purpose To determine impact of risk-reducing hysterectomy and bilateral salpingo-oophorectomy (BSO) on gynecological cancer incidence and death in heterozygotes of pathogenic MMR ( path_MMR ) variants. Methods The Prospective Lynch Syndrome Database was used to investigate the effects of gynecological risk-reducing surgery (RRS) at different ages. Results Risk-reducing hysterectomy at 25 years of age prevents endometrial cancer before 50 years in 15%, 18%, 13%, and 0% of path_MLH1 , path_MSH2 , path_MSH6 , and path_PMS2 heterozygotes and death in 2%, 2%, 1%, and 0%, respectively. Risk-reducing BSO at 25 years of age prevents ovarian cancer before 50 years in 6%, 11%, 2%, and 0% and death in 1%, 2%, 0%, and 0%, respectively. Risk-reducing hysterectomy at 40 years prevents endometrial cancer by 50 years in 13%, 16%, 11%, and 0% and death in 1%, 2%, 1%, and 0%, respectively. BSO at 40 years prevents ovarian cancer before 50 years in 4%, 8%, 0%, and 0%, and death in 1%, 1%, 0%, and 0%, respectively. Conclusion Little benefit is gained by performing RRS before 40 years of age and premenopausal BSO in path_MSH6 and path_PMS2 heterozygotes has no measurable benefit for mortality. These findings may aid decision making for women with LS who are considering RRS.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-04-01 |