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Assessing the Risk of Occult Cancer and 30-day Morbidity in Women Undergoing Risk-reducing Surgery: A Prospective Experience.

Abstract：

STUDY OBJECTIVE:To investigate the incidence and predictive factors of 30-day surgery-related morbidity and occult precancerous and cancerous conditions for women undergoing risk-reducing surgery. DESIGN:A prospective study (Canadian Task Force classification II-1). SETTING:A gynecologic oncology referral center. PATIENTS:Breast-related cancer antigen (BRCA) mutation carriers and BRCAX patients (those with a significant family history of breast and ovarian cancer). INTERVENTIONS:Minimally invasive risk-reduction surgery. MEASUREMENTS AND MAIN RESULTS:Overall, 85 women underwent risk-reducing surgery: 30 (35%) and 55 (65%) had hysterectomy plus bilateral salpingo-oophorectomy (BSO) and BSO alone, respectively. Overall, in 6 (7%) patients, the final pathology revealed unexpected cancer: 3 early-stage ovarian/fallopian tube cancers, 2 advanced-stage ovarian cancers (stage IIIA and IIIB), and 1 serous endometrial carcinoma. Additionally, 3 (3.6%) patients had incidental finding of serous tubal intraepithelial carcinoma. Four (4.7%) postoperative complications within 30 days from surgery were registered, including fever (n = 3) and postoperative ileus (n = 1); no severe (grade 3 or more) complications were observed. All complications were managed conservatively. The presence of occult cancer was the only factor predicting the development of postoperative complications (p = .02). CONCLUSION:Minimally invasive risk-reducing surgery is a safe and effective strategy to manage BRCA mutation carriers. Patients should benefit from an appropriate counseling about the high prevalence of undiagnosed cancers observed at the time of surgery.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Bogani G,Tagliabue E,Signorelli M,Chiappa V,Carcangiu ML,Paolini B,Casarin J,Scaffa C,Gennaro M,Martinelli F,Borghi C,Ditto A,Lorusso D,Raspagliesi F

doi

10.1016/j.jmig.2017.04.017

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

837-842

issue

5

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(17)30283-2

journal_volume

24

pub_type

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