Bilateral Oophorectomy and All-Cause Mortality in Women With BRCA1 and BRCA2 Sequence Variations

作者：Joanne Kotsopoulos, Jacek Gronwald, Tomasz Huzarski, Pål Møller, Tuya Pal, Jeanna Marie McCuaig, Christian Fridolin Singer, Beth Y. Karlan, Amber M. Aeilts, Charis Eng, Andrea F. Eisen, Louise J. Bordeleau, William David Foulkes, Nadine Tung, Fergus J. Couch, Robert Fruscio, Susan L. Neuhausen, Dana Zakalik, Cezary Cybulski, Kelly A. Metcalfe, Olufunmilayo Ibironke Olopade, Ping Sun, Jan Lubiński, Steven Alexander Narod, Kevin M. Sweet, Christine Elser, Georgia L. Wiesner, Aletta Poll, Raymond H. Kim, Susan Armel, Rochelle Demsky, Linda Roslyn Steele, Howard M. Saal, Kim Serfas, Seema Panchal, Carey A. Cullinane, Robert E. Reilly, Daniel Rayson, L J Mercer, Teresa Ramón y Cajal, Jeffrey S. Dungan, Stephanie A. Cohen, Edmond G. Lemire, Stefania Zovato, Antonella L. Rastelli · 发表于：JAMA Oncology · 年份：2024 · DOI：10.1001/jamaoncol.2023.6937 · 被引用次数：53 · 研究领域：BRCA gene mutations in cancer、Ovarian cancer diagnosis and treatment、Menopause: Health Impacts and Treatments

Importance: Preventive bilateral salpingo-oophorectomy is offered to women at high risk of ovarian cancer who carry a pathogenic variant in BRCA1 or BRCA2; however, the association of oophorectomy with all-cause mortality has not been clearly defined. Objective: To evaluate the association between bilateral oophorectomy and all-cause mortality among women with a BRCA1 or BRCA2 sequence variation. Design, Setting, and Participants: In this international, longitudinal cohort study of women with BRCA sequence variations, information on bilateral oophorectomy was obtained via biennial questionnaire. Participants were women with a BRCA1 or BRCA2 sequence variation, no prior history of cancer, and at least 1 follow-up questionnaire completed. Women were followed up from age 35 to 75 years for incident cancers and deaths. Cox proportional hazards regression was used to estimate the hazard ratios (HRs) and 95% CIs for all-cause mortality associated with a bilateral oophorectomy (time dependent). Data analysis was performed from January 1 to June 1, 2023. Exposures: Self-reported bilateral oophorectomy (with or without salpingectomy). Main Outcomes and Measures: All-cause mortality, breast cancer-specific mortality, and ovarian cancer-specific mortality. Results: There were 4332 women (mean age, 42.6 years) enrolled in the cohort, of whom 2932 (67.8%) chose to undergo a preventive oophorectomy at a mean (range) age of 45.4 (23.0-77.0) years. After a mean follow-up of 9.0 years, 851 wo...