International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2025
Interval versus primary cytoreductive surgery in BRCA-mutated advanced-stage ovarian/peritoneal/tubal carcinoma.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Rose Peter G, Patil Sujata, Yao Meng, Chambers Laura M, DeBernardo Robert, Michener Chad M, AlHilli Miriam, Vargas Roberto
Аннотация
OBJECTIVE: This study aimed to evaluate the impact of neoadjuvant chemotherapy and interval cytoreductive surgery versus primary cytoreductive surgery and adjuvant chemotherapy on progression-free survival, overall survival, and long-term disease-free survival in patients with International Federation of Gynecology and Obstetrics (FIGO) 2013 stage IIIC to IV BRCA-mutated (BRCAm) epithelial ovarian/peritoneal/tubal carcinoma and compare this with patients with BRCA wild-type (BRCAwt) epithelial ovarian/peritoneal/tubal carcinoma.
METHODS: A single-institution retrospective review of all patients epithelial ovarian/peritoneal/tubal carcinoma with BRCA germline and somatic mutations from 1991 to 2021 was performed via electronic medical records. All BRCAm cases were identified and compared with a representative cohort of patients with BRCAwt.
RESULTS: A total of 248 patients with germline (n = 236) or somatic (n = 12) BRCAm were identified and compared with 289 patients with BRCAwt. A total of 13 of 140 patients with FIGO 1988 stage IIIC with BRCAm (9.3%) were down-staged to IIIA (6.4%) or IIIB (2.9%) by FIGO 2013 staging. Significantly reduced operative time and surgical complexity was observed in patients with BRCAm stage IIIC and IV who underwent interval cytoreductive surgery compared with patients with BRCAm who underwent primary cytoreductive surgery. Similarly, patients with BRCAm who underwent interval cytoreductive surgery had significantly reduced surgical complexity compared with patients with BRCAwt who underwent interval cytoreductive surgery. No significant difference in progression-free survival was observed in those who underwent primary cytoreductive surgery versus interval cytoreductive surgery, although improved progression-free survival in the primary cytoreductive surgery group was noted in those who did not receive poly (ADP-ribose) polymerase inhibitors.
CONCLUSION: A significant improvement in overall survival was observed in those who underwent primary cytoreductive surgery, regardless of first-line poly (adenosine diphosphate-ribose) polymerase inhibitor maintenance. Long-term disease-free survivors (>10 years) were only identified in the primary cytoreductive surgery cohort.
METHODS: A single-institution retrospective review of all patients epithelial ovarian/peritoneal/tubal carcinoma with BRCA germline and somatic mutations from 1991 to 2021 was performed via electronic medical records. All BRCAm cases were identified and compared with a representative cohort of patients with BRCAwt.
RESULTS: A total of 248 patients with germline (n = 236) or somatic (n = 12) BRCAm were identified and compared with 289 patients with BRCAwt. A total of 13 of 140 patients with FIGO 1988 stage IIIC with BRCAm (9.3%) were down-staged to IIIA (6.4%) or IIIB (2.9%) by FIGO 2013 staging. Significantly reduced operative time and surgical complexity was observed in patients with BRCAm stage IIIC and IV who underwent interval cytoreductive surgery compared with patients with BRCAm who underwent primary cytoreductive surgery. Similarly, patients with BRCAm who underwent interval cytoreductive surgery had significantly reduced surgical complexity compared with patients with BRCAwt who underwent interval cytoreductive surgery. No significant difference in progression-free survival was observed in those who underwent primary cytoreductive surgery versus interval cytoreductive surgery, although improved progression-free survival in the primary cytoreductive surgery group was noted in those who did not receive poly (ADP-ribose) polymerase inhibitors.
CONCLUSION: A significant improvement in overall survival was observed in those who underwent primary cytoreductive surgery, regardless of first-line poly (adenosine diphosphate-ribose) polymerase inhibitor maintenance. Long-term disease-free survivors (>10 years) were only identified in the primary cytoreductive surgery cohort.