JAMA Oncol: Preventive salpingectomy for BRCA1/2 gene mutation carriers, quality of life is still good after surgery

The results of a non-randomized controlled trial of Dutch researchers Steenbeek other reports show that no matter how hormone replacement therapy, prevention of sexual salpingectomy (RRS) menopause-related quality of life is better than reducing the risk of salpingo-oophorectomy (RRSO ) After the patient
.

An international follow-up study is currently evaluating the tumor safety of this therapy

Prevent JAMA

Since the current method of preventing ovarian cancer is RRSO, most women with BRCA1/2 pathogenic variants have experienced premature menopause and have potential short-term and long-term morbidity
.

Because the fallopian tube plays a key role in the pathogenesis of ovarian cancer, salpingectomy and delayed oophorectomy may be a new risk reduction strategy and have the benefit of delaying menopause

Ovarian cancer

This study aims to compare the risk-reducing salpingectomy (RRS) and delayed ovariectomy and the quality of life related to menopause after RRSO in carriers of BRCA1/2 pathogenic variants
.

From January 16, 2015 to November 7, 2019, a multicenter non-randomized controlled trial (TUBA study) recruited patients in a large general hospital in the Netherlands and followed up at 3 and 12 months after surgery
.

The conditions for enrolling patients are: patients aged 25-40 years (BRCA1) or 25-45 years (BRCA2) in the clinical genetics department or gynecology department, and have completed childbirth before menopause, and are currently not receiving tumor-related treatment

Undergoing risk-reducing salpingo-oophorectomy at the current recommended age, or receiving RRS combined with delayed ovariectomy after the completion of childbirth
.

After receiving RRSO, hormone replacement therapy is recommended for women without contraindications

The main result uses the Greene Menopause Scale to assess menopausal-related quality of life.
The higher the total score of the scale (range 0-63), the more menopausal symptoms
.

Secondary outcomes are health-related quality of life, sexual function and pain, tumor concerns, decision regrets, and surgical results

A total of 577 women (average age 37.
2 years) were included in the study, including 297 (51.
5%) BRCA1 pathogenic carriers and 280 (48.
5%) BRCA2 pathogenic carriers
.

At the time of analysis, 394 patients underwent RRS and 154 patients underwent RRSO

Original source:

Steenbeek MP, Harmsen MG, Hoogerbrugge N, de Jong MA, Maas AHEM, Prins JB, Bulten J, Teerenstra S, van Bommel MHD, van Doorn HC, Mourits MJE, van Beurden M, Zweemer RP, Gaarenstroom KN, Slangen BFM, Brood -van Zanten MMA, Vos MC, Piek JMJ, van Lonkhuijzen LRCW, Apperloo MJA, Coppus SFPJ, Massuger LFAG, IntHout J, Hermens RPMG, de Hullu JA.

Steenbeek MP, Harmsen MG, Hoogerbrugge N, de Jong MA, Maas AHEM, Prins JB, Bulten J, Teerenstra S, van Bommel MHD, van Doorn HC, Mourits MJE, van Beurden M, Zweemer RP, Gaarenstroom KN, Slangen BFM, Brood -van Zanten MMA, Vos MC, Piek JMJ, van Lonkhuijzen LRCW, Apperloo MJA, Coppus SFPJ, Massuger LFAG, IntHout J, Hermens RPMG, de Hullu JA.
Association of Salpingectomy With Delayed Oophorectomy Versus Salpingo-oophorectomy With Quality of Life in BRCA1 / 2 Pathogenic the Variant Carriers: A nonrandomized Controlled Trial.
JAMA 2021-Aug Oncol.
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