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Uptake of hysterectomy and bilateral salpingooophorectomy in carriers of pathogenic mismatch repair variants: a Prospective Lynch Syndrome Database report

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العنوان: Uptake of hysterectomy and bilateral salpingooophorectomy in carriers of pathogenic mismatch repair variants: a Prospective Lynch Syndrome Database report
المؤلفون: Seppala, T.T., Dominguez-Valentin, M., Crosbie, E.J., Engel, C., Aretz, S., Macrae, F., Winship, I., Capella, G., Thomas, H., Hovig, E., Nielsen, M., Sijmons, R.H., Bertario, L., Bonanni, B., Tibiletti, M.G., Cavestro, G.M., Mints, M., Gluck, N., Katz, L., Heinimann, K., Vaccaro, C.A., Green, K., Lalloo, F., Hill, J., Schmiegel, W., Vangala, D., Perne, C., Strauss, H.G., Tecklenburg, J., Holinski-Feder, E., Steinke-Lange, V., Mecklin, J.P., Plazzer, J.P., Pineda, M., Navarro, M., Vida, J.B., Kariv, R., Rosner, G., Pinero, T.A., Pavicic, W., Kalfayan, P., Broeke, S.W. ten, Jenkins, M.A., Sunde, L., Bernstein, I., Burn, J., Greenblatt, M., Cappel, W.H.D.T.N., Valle, A. della, Lopez-Koestner, F., Alvarez, K., Buttner, R., Gorgens, H., Morak, M., Holzapfel, S., Huneburg, R., Doeberitz, M.V., Loeffler, M., Redler, S., Weitz, J., Pylvanainen, K., Renkonen-Sinisalo, L., Lepisto, A., Hopper, J.L., Win, A.K., Lindor, N.M., Gallinger, S., Marchand, L.L., Newcomb, P.A., Figueiredo, J.C., Thibodeau, S.N., Therkildsen, C., Wadt, K.A.W., Mourits, M.J.E., Ketabi, Z., Denton, O.G., Rodland, E.A., Vasen, H., Neffa, F., Esperon, P., Tjandra, D., Moslein, G., Rokkones, E., Sampson, J.R., Evans, D.G., Moller, P.
المصدر: European Journal of Cancer
سنة النشر: 2021
المجموعة: Leiden Repository (Leiden University)
مصطلحات موضوعية: Lynch syndrome, Endometrial cancer, Ovarian cancer, Risk-reducing surgery, Hysterectomy, Oophorectomy, MLH1, MSH2, MSH6, PMS2
الوصف: 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. ; Hereditary cancer genetics
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: English
العلاقة: http://www.ejcancer.com/article/S0959804921001052/pdfTest; lumc-id: 116125929; https://hdl.handle.net/1887/3196213Test
DOI: 10.1016/j.ejca.2021.02.022
الإتاحة: https://doi.org/10.1016/j.ejca.2021.02.022Test
https://hdl.handle.net/1887/3196213Test
http://www.ejcancer.com/article/S0959804921001052/pdfTest
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Array ( [Name] => Abstract [Label] => Description [Group] => Ab [Data] => 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. ; Hereditary cancer genetics )
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[84] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Evans, D.G. ) ) ) [85] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Moller, P. ) ) ) ) [IsPartOfRelationships] => Array ( [0] => Array ( [BibEntity] => Array ( [Dates] => Array ( [0] => Array ( [D] => 01 [M] => 01 [Type] => published [Y] => 2021 ) ) [Identifiers] => Array ( [0] => Array ( [Type] => issn-locals [Value] => edsbas ) ) [Titles] => Array ( [0] => Array ( [TitleFull] => European Journal of Cancer [Type] => main ) ) ) ) ) ) )
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