Abstract
ObjectivesTo compare clinical–pathological characteristics and outcome between sporadic ovarian cancer and ovarian cancer in patents with hereditary breast and ovarian cancer syndrome (HBOC).MethodsTwenty-four patients with ovarian cancer treated between 2000 and 2009 who tested positive for BRCA1/2 mutation (BRCA+) and a control group of 64 age-matched patients with no family history of breast/ovarian cancer (controls) were enrolled. Clinical–pathological characteristics, surgical outcome, overall (OS), and progression-free survival (PFS) were compared between the two groups.ResultsThe high-grade serous histotype was more represented in BRCA+ than in controls (70.8% versus 53.1%) (p > 0.05). BRCA+ cancers were more frequently diagnosed at stage II than controls (20.83% versus 4.69%) (p = 0.024). Radical primary surgery was performed in 70% of women in both groups, with no difference in debulking results. In patients undergoing surgery after neoadjuvant chemotherapy, in all BRCA+ patients, optimal cytoreduction was achieved (versus 70% of the controls). PFS was significantly longer for BRCA+ patients compared to controls (60 months versus 22 months; p = 0.039). No significant difference was observed in OS between BRCA+ patients and controls.ConclusionsAt a median follow-up time of 46 months, BRCA+ patients have a better prognosis than controls in terms of PFS. Higher chemosensitivity of BRCA+ tumours was observed.
Highlights
The estimated lifetime risk of ovarian cancer in BRCA1 mutation carriers is 40% to 50%, among BRCA2 mutation carriers the risk is lower, ranging from 20% to 30% [1], while the lifetime risk of ovarian cancer in the general population is 1.6%
Most ovarian cancers associated with hereditary breast and ovarian cancer syndrome (HBOC) reported in the literature are high-grade and advanced-stage serous carcinomas, whereas borderline and mucinous tumours are uncommon [4]
Ovarian cancers in patients with HBOC are associated with unfavourable pathological characteristics but with a higher chemosensitivity, [2, 5, 6, 7, 8, 9] as described in the term ‘BRCAness’ phenotype [10, 11]
Summary
The estimated lifetime risk of ovarian cancer in BRCA1 mutation carriers is 40% to 50%, among BRCA2 mutation carriers the risk is lower, ranging from 20% to 30% [1], while the lifetime risk of ovarian cancer in the general population is 1.6%. Most ovarian cancers associated with hereditary breast and ovarian cancer syndrome (HBOC) reported in the literature are high-grade and advanced-stage serous carcinomas, whereas borderline and mucinous tumours are uncommon [4]. Ovarian cancers in patients with HBOC are associated with unfavourable pathological characteristics but with a higher chemosensitivity, [2, 5, 6, 7, 8, 9] as described in the term ‘BRCAness’ phenotype [10, 11]. We compare clinical–pathological characteristics and outcome, in terms of overall survival (OS) and progression-free survival (PFS), of HBOC and sporadic ovarian cancer
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