Abstract
ObjectiveTo evaluate impact of germline BRCA mutational status on prognosis in patients with advanced ovarian cancer.MethodsA total of 128 patients diagnosed with FIGO stage III-IV high-grade serous ovarian cancer (HGSOC) between 2008 and 2017 and underwent BRCA1/2 gene testing at the time of or within two years from cancer diagnosis were included in this study. We compared patients’ clinicopathological characteristics and survival outcomes after primary treatment according to germline BRCA mutational status. Treatment-related factors that might affect patients’ survival outcome were also investigated.ResultsGermline BRCA1/2 mutations were observed in 51 women (39.8%). There were no differences in age and serum CA-125 levels at the time of HGSOC diagnosis, use of neoadjuvant chemotherapy (NAC), extent of debulking surgery, and overall survival (OS) between the BRCA mutation and wild-type BRCA groups. In contrast, the BRCA mutation group displayed longer progression-free survival (PFS) (median, 22.9 vs. 16.9 months, P = 0.001). Multivariate analyses identified germline BRCA1/2 mutation as an independent favorable prognostic factor for PFS (adjusted HR, 0.502; 95% CI, 0.318–0.795; P = 0.003). In the wild-type BRCA group, patients who received NAC as the primary treatment had shorter PFS compared to those who received primary debulking surgery (PDS) (median, 14.2 vs. 16.9 months, P = 0.003). However, in the BRCA mutation group, PFS did not differ between the NAC and PDS groups (P = 0.082).ConclusionsIn advanced-stage HGSOC, patients with germline BRCA1/2 mutations have better prognosis with longer PFS than those lacking BRCA mutations. Prognosis after NAC was different according to the BRCA mutational status.
Highlights
Ovarian cancer is the deadliest gynecologic malignancy, accounting for 226,000 new cases and 158,000 cancer deaths globally each year [1]
No differences in age and serum CA-125 levels at the time of High-grade serous ovarian cancer (HGSOC) diagnosis, use of neoadjuvant chemotherapy (NAC), and rates of optimal debulking surgery were observed between the BRCA mutation group and the wild-type BRCA group
In the BRCA1/2 mutation group, stage IV disease were more frequent in NAC group, progression-free survival (PFS) did not differ between the NAC and primary debulking surgery (PDS) groups (P = 0.082)
Summary
Ovarian cancer is the deadliest gynecologic malignancy, accounting for 226,000 new cases and 158,000 cancer deaths globally each year [1]. Germline mutations in BRCA1 or BRCA2 gene confer a high risk of developing ovarian cancer [3, 4]. A recent prospective cohort study estimated the cumulative ovarian cancer risk to age 80 years as 44% (95% confidence interval [CI], 36–53%) for BRCA1 and 17% (95% CI, 11–25%) for BRCA2 mutation carriers [4]. High-grade serous ovarian cancer (HGSOC), the most prevalent and lethal form among EOCs, is of particular interest because approximately 20% of patients with this histology have germline BRCA1/2 mutations [6]. The ability to identify patients with germline BRCA1/2 mutations and evaluate their clinical outcomes are important issues in HGSOC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
