Amy P M Finch1, Jan Lubinski1, Pål Møller1, Christian F Singer1, Beth Karlan1, Leigha Senter1, Barry Rosen1, Lovise Maehle1, Parviz Ghadirian1, Cezary Cybulski1, Tomasz Huzarski1, Andrea Eisen1, William D Foulkes1, Charmaine Kim-Sing1, Peter Ainsworth1, Nadine Tung1, Henry T Lynch1, Susan Neuhausen1, Kelly A Metcalfe1, Islay Thompson1, Joan Murphy1, Ping Sun1, Steven A Narod2. 1. Amy P.M. Finch, Barry Rosen, Andrea Eisen, Kelly A. Metcalfe, Islay Thompson, Joan Murphy, Ping Sun, and Steven A. Narod, University of Toronto; Barry Rosen and Joan Murphy, Princess Margaret Hospital; Amy P.M. Finch, Islay Thompson, Ping Sun, and Steven A. Narod, Women's College Research Institute; Andrea Eisen, Sunnybrook Odette Cancer Center, Toronto; Peter Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, University of Montreal Hospital Centre; William D. Foulkes, McGill University, Montreal, Quebec; Charmaine Kim-Sing, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Jan Lubinski, Cezary Cybulski, and Tomasz Huzarski, Pomeranian Medical University, Szczecin, Poland; Pål Møller and Lovise Maehle, Norwegian Radium Hospital and Oslo University Hospital, Oslo, Norway; Christian F. Singer, Medical University of Vienna, Vienna, Austria; Beth Karlan, Cedars-Sinai Medical Center, Beverly Hills; Susan Neuhausen, City of Hope National Medical Center, Duarte, CA; Leigha Senter, Ohio State University Medical Center, Columbus, OH; Nadine Tung, Beth Israel Deaconess Medical Center, Boston, MA; and Henry T. Lynch, Creighton University School of Medicine, Omaha, NE. 2. Amy P.M. Finch, Barry Rosen, Andrea Eisen, Kelly A. Metcalfe, Islay Thompson, Joan Murphy, Ping Sun, and Steven A. Narod, University of Toronto; Barry Rosen and Joan Murphy, Princess Margaret Hospital; Amy P.M. Finch, Islay Thompson, Ping Sun, and Steven A. Narod, Women's College Research Institute; Andrea Eisen, Sunnybrook Odette Cancer Center, Toronto; Peter Ainsworth, London Regional Cancer Program, London, Ontario; Parviz Ghadirian, University of Montreal Hospital Centre; William D. Foulkes, McGill University, Montreal, Quebec; Charmaine Kim-Sing, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Jan Lubinski, Cezary Cybulski, and Tomasz Huzarski, Pomeranian Medical University, Szczecin, Poland; Pål Møller and Lovise Maehle, Norwegian Radium Hospital and Oslo University Hospital, Oslo, Norway; Christian F. Singer, Medical University of Vienna, Vienna, Austria; Beth Karlan, Cedars-Sinai Medical Center, Beverly Hills; Susan Neuhausen, City of Hope National Medical Center, Duarte, CA; Leigha Senter, Ohio State University Medical Center, Columbus, OH; Nadine Tung, Beth Israel Deaconess Medical Center, Boston, MA; and Henry T. Lynch, Creighton University School of Medicine, Omaha, NE. steven.narod@wchospital.ca.
Abstract
PURPOSE: The purposes of this study were to estimate the reduction in risk of ovarian, fallopian tube, or peritoneal cancer in women with a BRCA1 or BRCA2 mutation after oophorectomy, by age of oophorectomy; to estimate the impact of prophylactic oophorectomy on all-cause mortality; and to estimate 5-year survival associated with clinically detected ovarian, occult, and peritoneal cancers diagnosed in the cohort. PATIENTS AND METHODS: Women with a BRCA1 or BRCA2 mutation were identified from an international registry; 5,783 women completed a baseline questionnaire and ≥ one follow-up questionnaires. Women were observed until either diagnosis of ovarian, fallopian tube, or peritoneal cancer, death, or date of most recent follow-up. Hazard ratios (HRs) for cancer incidence and all-cause mortality associated with oophorectomy were evaluated using time-dependent survival analyses. RESULTS: After an average follow-up period of 5.6 years, 186 women developed either ovarian (n = 132), fallopian (n = 22), or peritoneal (n = 32) cancer, of whom 68 have died. HR for ovarian, fallopian, or peritoneal cancer associated with bilateral oophorectomy was 0.20 (95% CI, 0.13 to 0.30; P < .001). Among women who had no history of cancer at baseline, HR for all-cause mortality to age 70 years associated with an oophorectomy was 0.23 (95% CI, 0.13 to 0.39; P < .001). CONCLUSION: Preventive oophorectomy was associated with an 80% reduction in the risk of ovarian, fallopian tube, or peritoneal cancer in BRCA1 or BRCA2 carriers and a 77% reduction in all-cause mortality.
PURPOSE: The purposes of this study were to estimate the reduction in risk of ovarian, fallopian tube, or peritoneal cancer in women with a BRCA1 or BRCA2 mutation after oophorectomy, by age of oophorectomy; to estimate the impact of prophylactic oophorectomy on all-cause mortality; and to estimate 5-year survival associated with clinically detected ovarian, occult, and peritoneal cancers diagnosed in the cohort. PATIENTS AND METHODS: Women with a BRCA1 or BRCA2 mutation were identified from an international registry; 5,783 women completed a baseline questionnaire and ≥ one follow-up questionnaires. Women were observed until either diagnosis of ovarian, fallopian tube, or peritoneal cancer, death, or date of most recent follow-up. Hazard ratios (HRs) for cancer incidence and all-cause mortality associated with oophorectomy were evaluated using time-dependent survival analyses. RESULTS: After an average follow-up period of 5.6 years, 186 women developed either ovarian (n = 132), fallopian (n = 22), or peritoneal (n = 32) cancer, of whom 68 have died. HR for ovarian, fallopian, or peritoneal cancer associated with bilateral oophorectomy was 0.20 (95% CI, 0.13 to 0.30; P < .001). Among women who had no history of cancer at baseline, HR for all-cause mortality to age 70 years associated with an oophorectomy was 0.23 (95% CI, 0.13 to 0.39; P < .001). CONCLUSION: Preventive oophorectomy was associated with an 80% reduction in the risk of ovarian, fallopian tube, or peritoneal cancer in BRCA1 or BRCA2 carriers and a 77% reduction in all-cause mortality.
Authors: Timothy R Rebbeck; Tara Friebel; Theresa Wagner; Henry T Lynch; Judy E Garber; Mary B Daly; Claudine Isaacs; Olufunmilayo I Olopade; Susan L Neuhausen; Laura van 't Veer; Rosalind Eeles; D Gareth Evans; Gail Tomlinson; Ellen Matloff; Steven A Narod; Andrea Eisen; Susan Domchek; Katrina Armstrong; Barbara L Weber Journal: J Clin Oncol Date: 2005-10-11 Impact factor: 44.544
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Authors: Kelly A Metcalfe; Daphna Birenbaum-Carmeli; Jan Lubinski; Jacek Gronwald; Henry Lynch; Pal Moller; Parviz Ghadirian; William D Foulkes; Jan Klijn; Eitan Friedman; Charmaine Kim-Sing; Peter Ainsworth; Barry Rosen; Susan Domchek; Teresa Wagner; Nadine Tung; Siranoush Manoukian; Fergus Couch; Ping Sun; Steven A Narod Journal: Int J Cancer Date: 2008-05-01 Impact factor: 7.396
Authors: Andrea Eisen; Jan Lubinski; Jacek Gronwald; Pal Moller; Henry T Lynch; Jan Klijn; Charmaine Kim-Sing; Susan L Neuhausen; Lucy Gilbert; Parviz Ghadirian; Siranoush Manoukian; Gad Rennert; Eitan Friedman; Claudine Isaacs; Eliot Rosen; Barry Rosen; Mary Daly; Ping Sun; Steven A Narod Journal: J Natl Cancer Inst Date: 2008-09-23 Impact factor: 13.506
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