Patient-Centered Approach to Surgical Prevention of Ovarian Cancer

作者：Karen H. Lu, Barbara M. Norquist, Gary B. Chisholm, Christine B. Peterson, Kara Long Roche, Jamie Nadine Bakkum-Gamez, Iris L. Romero, Colleen Feltmate, Douglas A. Levine, Sarah Kim, Andrea R. Hagemann, Jeanne Carter, Martha Hickey, Jamie Crase, Kathleen Gavin, Deborah Polinsky, Alan D. D’Andrea, Denise R. Nebgen, Elizabeth M. Swisher · 发表于：JAMA Network Open · 年份：2026 · DOI：10.1001/jamanetworkopen.2026.22026 · 被引用次数：3 · 研究领域：Ovarian cancer diagnosis and treatment、BRCA gene mutations in cancer、Menopause: Health Impacts and Treatments

Importance: Risk-reducing salpingo-oophorectomy (RRSO) is an effective option to prevent ovarian cancer in high-risk individuals, but adverse effects from premature menopause are a barrier to uptake. Interval salpingectomy with delayed oophorectomy (ISDO) may be an effective alternative. Objective: To evaluate the association of ISDO vs RRSO and sexual function and menopausal symptoms. Design, Setting, and Participants: This prospective, multicenter, nonrandomized (patient preference) clinical trial was performed among Women Choosing Surgical Prevention participants with a pathogenic or likely pathogenic germline variant conferring an increased risk for ovarian cancer. Patients from 9 US centers were enrolled from June 2, 2016, to October 28, 2020; chose ISDO or RRSO; and were followed up for 24 months. The analysis was performed on November 13, 2024. Interventions: Participant-selected RRSO or ISDO. Main Outcomes and Measures: Changes in sexual function and menopausal symptoms from baseline to 6, 12, and 24 months. Inverse probability weighting was applied to achieve covariate balance across groups. Results: The analytic sample included 334 female participants (mean [95% CI] age at consent, 39.2 [38.7-.9.7] years) who underwent RRSO (n = 165) or ISDO (n = 169) and completed 6-month questionnaires. Significantly more participants experienced clinically meaningful worsening of sexual function at 6 months compared with baseline after RRSO vs ISDO (33.1% [39 of 118] vs 16.8% [17...