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Ataseven B, Tripon D, Schwameis R, Harter P, Rhiem K, Schneider S, Heikaus S, Baert T, Francesco AP, Heitz F, Traut A, Groeben HT, Schmutzler R, du Bois A. Clinical outcome in patients with primary epithelial ovarian cancer and germline BRCA1/2-mutation - real life data. Gynecol Oncol 2021; 163:569-577. [PMID: 34565600 DOI: 10.1016/j.ygyno.2021.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND We evaluated the clinical impact of germline (g)BRCA1/2-mutation on initial disease presentation, surgical implications, surgical morbidity and survival in patients with advanced epithelial ovarian cancer (EOC) undergoing debulking surgery (DS). METHODS Data of all consecutive EOC patients with stage III/IV, high-grade serous disease and known gBRCA1/2 status (gBRCA; non-gBRCA), who underwent DS at our department between 01/2011 and 06/2019 were analyzed. Associations between gBRCA-status and severe postoperative complications and survival were analyzed. RESULTS gBRCA-status was determined in 50.1% (612/1221) of all patients. gBRCA was present in 21.9% (134/612). Significant differences were observed in terms of median age (p = 0.001) and histology (high-grade serous histology gBRCA: 98.5%, non-gBRCA 76.2%; p < 0.001). gBRCA-status had no impact on intraoperative disease presentation, surgical complexity or complete resection rate (gBRCA: 74.4%, non-gBRCA: 69.0%; p = 0.274). gBRCA-status was not predictive for severe postoperative complication (gBRCA: 12.0%, non-gBRCA: 19.1%; p = 0.082). Median PFS and OS was 31/22 and 71/53 months in patients with/without gBRCA-mutation, respectively. gBRCA was a significant prognostic factor for PFS (HR 0.57 p < 0.001) and for OS (HR 0.64, p = 0.048) after adjusting for established prognostic factors. CONCLUSIONS gBRCA-status had no impact on initial disease presentation, surgical results or postoperative complications. gBRCA patients have a significantly longer PFS but the impact on the long term prognosis is unclear. Complete resection remains the most important prognostic factor in patients with EOC independent of gBRCA-status.
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Affiliation(s)
- Beyhan Ataseven
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany; Department of Obstetrics and Gynecology, University Hospital, LMU, Munich, Germany.
| | - Denise Tripon
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany; Department of Obstetrics and Gynecology, University Hospital, LMU, Munich, Germany
| | - Richard Schwameis
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany; Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria
| | - Philipp Harter
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Stephanie Schneider
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany
| | | | - Thaïs Baert
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany; Department of Oncology, Laboratory of Tumour Immunology and Immunotherapy, ImmunOvar Research Group, KU Leuven, Leuven, Belgium
| | | | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany; Department of Gynecology, Campus Virchow Clinic, Charité Medical University, Berlin, Germany
| | - Alexander Traut
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany
| | - Harald-Thomas Groeben
- Department of Anesthesiology and Intensive Care, Kliniken Essen-Mitte, Essen, Germany
| | - Rita Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Andreas du Bois
- Department of Gynecology and Gynecologic Oncology, Evang, Kliniken Essen-Mitte, Essen, Germany
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Tripon D, Harter P, Rhiem K, Schneider S, du Bois A, Heitz F, Baert T, Traut A, Pauly N, Ehmann S, Schmutzler R, Ataseven B. Prävalenz von BRCA1 and BRCA2 Mutationen bei Patientinnen mit primärem Ovarialkarzinom – Bildet die deutsche Checkliste zur Erfassung des Risikos für familiären Brust-/und Eierstockkrebs den Beratungsbedarf ausreichend ab? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- D Tripon
- Kliniken Essen-Mitte
- LMU Klinik für Frauenheilkunde und Geburtshilfe
| | | | - K Rhiem
- Zentrum Familiärer Brust- und Eierstockkrebs
| | | | | | - F Heitz
- Kliniken Essen-Mitte
- Charite Berlin, Gynäkologie
| | - T Baert
- Kliniken Essen-Mitte
- Department of Oncology, Laboratory of Tumour Immunology and Immunotherapy, ImmunOvar Research Group
| | | | | | | | | | - B Ataseven
- Kliniken Essen-Mitte
- LMU Klinik für Frauenheilkunde und Geburtshilfe
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Ataseven B, Tripon D, Rhiem K, Harter P, Schneider S, Heitz F, Baert T, Traut A, Pauly N, Ehmann S, Plett H, Schmutzler RK, du Bois A. Prevalence of BRCA1 and BRCA2 Mutations in Patients with Primary Ovarian Cancer - Does the German Checklist for Detecting the Risk of Hereditary Breast and Ovarian Cancer Adequately Depict the Need for Consultation? Geburtshilfe Frauenheilkd 2020; 80:932-940. [PMID: 32905297 PMCID: PMC7467803 DOI: 10.1055/a-1222-0042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/14/2020] [Indexed: 01/09/2023] Open
Abstract
BackgroundBRCA1/2
mutations are the leading cause of hereditary epithelial ovarian cancer (EOC). The German Consortium for Hereditary Breast and Ovarian Cancer has defined inclusion criteria, which are retrievable as a checklist and facilitate genetic counselling/testing for affected persons with a mutation probability of ≥ 10%. Our objective was to evaluate the prevalence of the
BRCA1/2
mutation(s) based on the checklist score (CLS).
Methods
A retrospective data analysis was performed on EOC patients with a primary diagnosis treated between 1/2011 – 5/2019 at the Central Essen Clinics, where a
BRCA1/2
genetic analysis result and a CLS was available. Out of 545 cases with a
BRCA1/2
result (cohort A), 453 cases additionally had an extended gene panel result (cohort B).
Results
A
BRCA1/2
mutation was identified in 23.3% (127/545) in cohort A, pathogenic mutations in non-
BRCA1/2
genes were revealed in a further 6.2% in cohort B. In cohort A, 23.3% (127/545) of patients had a
BRCA1
(n = 92) or
BRCA2
(n = 35) mutation. Singular EOC (CLS 2) was present in 40.9%. The prevalence for a
BRCA1/2
mutation in cohort A was 10.8%, 17.2%, 25.0%, 35.1%, 51.4% and 66.7% for patients with CLS 2, 3, 4, 5, 6 and ≥ 7 respectively. The mutation prevalence in cohort B was 15.9%, 16.4%, 28.2%, 40.4%, 44.8% and 62.5% for patients with CLS 2, 3, 4, 5, 6 and ≥ 7 respectively.
Conclusions
The
BRCA1/2
mutation prevalence in EOC patients positively correlates with a rising checklist score. Already with singular EOC, the prevalence of a
BRCA1/2
mutation exceeds the required 10% threshold. Our data support the recommendation of the S3 guidelines Ovarian Cancer of offering genetic testing to all patients with EOC. Optimisation of the checklist with clear identification of the testing indication in this population should therefore be aimed for.
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Affiliation(s)
- Beyhan Ataseven
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen.,Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der LMU München, München
| | - Denise Tripon
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen
| | - Kerstin Rhiem
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinik Köln, Köln
| | - Philipp Harter
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen
| | - Stephanie Schneider
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen
| | - Florian Heitz
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen.,Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie (CVK) und Klinik für Gynäkologie (CBF), Charité - Universitätsmedizin Berlin, Berlin
| | - Thais Baert
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen.,Abteilung für Onkologie und Tumorimmunologie, KU Leuven, Leuven, Belgien
| | - Alexander Traut
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen
| | - Nina Pauly
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen
| | - Sarah Ehmann
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen
| | - Helmut Plett
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen.,Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie (CVK) und Klinik für Gynäkologie (CBF), Charité - Universitätsmedizin Berlin, Berlin
| | - Rita K Schmutzler
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinik Köln, Köln
| | - Andreas du Bois
- Abteilung für Gynäkologie und Gynäkologische Onkologie, Evang. Kliniken Essen-Mitte, Essen
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