Objective: To evaluate the effectiveness of transvaginal ultrasound (TVU) and serum CA-125 measurement in women at different risk of developing ovarian cancer/fallopian tube cancer (OC/FTC) and the incidence of primary peritoneal cancer (PPC) after risk-reducing salpingo-oophorectomy (RRSO). Methods: Between 2002 and 2014, 661 women at different risk of OC/FTC/PPC due to a family history or BRCA1/2 gene mutation were offered TVU and CA-125 measurement or RRSO as prevention strategies. The detection rate of OC/FTC/PPC was evaluated, and the sensitivity and specificity for CA-125 measurement and TVU were calculated. Survival and event analysis was performed for diagnosed patients. Results: After a median follow-up of 112 months, 12 OC/FTC/PPC cases were detected (2.6/1,000 persons/year). The screening sensitivity was 70%, with 73% for BRCA carriers. Six (50%) of 12 cancers were stage I or II. Among 41 women who underwent RRSO, 2 BRCA1 carriers developed a PPC (4.9%). At 61-month follow-up, overall and event-free survival were 75 and 64%, respectively. Conclusions: The cancer detection rate in women with BRCA mutation or a strong family history supports the effectiveness of our surveillance program for early diagnosis. Screening for women at lower risk of OC/FTC is not recommended. A residual risk of PPC after RRSO remains for BRCA1 carriers.
Evaluation of Transvaginal Ultrasound plus CA-125 Measurement and Prophylactic Salpingo-Oophorectomy in Women at Different Risk Levels of Ovarian Cancer: The Modena Study Group Cohort Study / Cortesi, Laura; De Matteis, Elisabetta; Toss, Angela; Marchi, Isabella; Medici, Veronica; Contu, Giannina; Xholli, Anjeza; Grandi, Giovanni; Cagnacci, Angelo; Federico, Massimo. - In: ONCOLOGY. - ISSN 0030-2414. - 93:6(2017), pp. 377-386.
Data di pubblicazione: | 2017 |
Data di prima pubblicazione: | 26-ago-2017 |
Titolo: | Evaluation of Transvaginal Ultrasound plus CA-125 Measurement and Prophylactic Salpingo-Oophorectomy in Women at Different Risk Levels of Ovarian Cancer: The Modena Study Group Cohort Study |
Autore/i: | Cortesi, Laura; De Matteis, Elisabetta; Toss, Angela; Marchi, Isabella; Medici, Veronica; Contu, Giannina; Xholli, Anjeza; Grandi, Giovanni; Cagnacci, Angelo; Federico, Massimo |
Autore/i UNIMORE: | |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1159/000479155 |
Rivista: | |
Volume: | 93 |
Fascicolo: | 6 |
Pagina iniziale: | 377 |
Pagina finale: | 386 |
Codice identificativo ISI: | WOS:000418640900005 |
Codice identificativo Scopus: | 2-s2.0-85028748819 |
Codice identificativo Pubmed: | 28848147 |
Citazione: | Evaluation of Transvaginal Ultrasound plus CA-125 Measurement and Prophylactic Salpingo-Oophorectomy in Women at Different Risk Levels of Ovarian Cancer: The Modena Study Group Cohort Study / Cortesi, Laura; De Matteis, Elisabetta; Toss, Angela; Marchi, Isabella; Medici, Veronica; Contu, Giannina; Xholli, Anjeza; Grandi, Giovanni; Cagnacci, Angelo; Federico, Massimo. - In: ONCOLOGY. - ISSN 0030-2414. - 93:6(2017), pp. 377-386. |
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