Improved quality of risk-reducing salpingo-oophorectomy in Australasian women at high risk of pelvic serous cancer
AuthorLee, YC; Bressel, M; Grant, P; Russell, P; Smith, C; Picken, S; Camm, S; Kiely, BE; Milne, RL; McLachlan, SA; ...
Source TitleFamilial Cancer
University of Melbourne Author/sPhillips, Kelly-Anne; Milne, Roger; Hickey, Martha; Hopper, John; McLachlan, Sue-Anne; Grant, Peter; Lee, Yeh
AffiliationMelbourne School of Population and Global Health
Sir Peter MacCallum Department of Oncology
Obstetrics and Gynaecology
Medicine and Radiology
Document TypeJournal Article
CitationsLee, Y. C., Bressel, M., Grant, P., Russell, P., Smith, C., Picken, S., Camm, S., Kiely, B. E., Milne, R. L., McLachlan, S. A., Hickey, M., Friedlander, M. L., Hopper, J. L. & Phillips, K. A. (2017). Improved quality of risk-reducing salpingo-oophorectomy in Australasian women at high risk of pelvic serous cancer. FAMILIAL CANCER, 16 (4), pp.461-469. https://doi.org/10.1007/s10689-017-9977-x.
Access StatusOpen Access
OBJECTIVES: The quality of risk-reducing salpingo-oophorectomy (RRSO) performed in Australasian women was previously reported to be suboptimal. Here we describe the quality of RRSO performed since 2008 in women enrolled in the same cohort and determine whether it has improved. DESIGN: Prospective cohort study of women at high risk of pelvic serous cancer (PSC) in kConFab. Eligible women had RRSO between 2008 and 2014 and their RRSO surgical and pathology reports were reviewed. "Adequate" surgery and pathology were defined as complete removal and paraffin embedding of all ovarian and extra-uterine fallopian tube tissue, respectively. Associations between clinical factors and "adequate" pathology were assessed using logistic regression. Data were compared with published cohort data on RRSO performed prior to 2008 using Chi square test. RESULTS: Of 164 contemporary RRSOs performed in 78 centres, 158/159 (99%) had "adequate" surgery and 108/164 (66%) had "adequate" pathology. Surgery performed by a gynaecologic oncologist rather than a general gynaecologist [OR 8.2, 95%CI (3.6-20.4), p < 0.001], surgery without concurrent hysterectomy [OR 2.5, 95%CI (1.1-6.0), p = 0.03], more recent year of surgery [OR 1.4, 95%CI (1.1-1.8), p = 0.02], and clinical notation that indicated high risk [OR 19.4, 95%CI (3.1-385), p = 0.008] were independently associated with "adequate" pathology. Both surgery and pathology were significantly more likely to be "adequate" (p < 0.001) in this contemporary sample. CONCLUSION: The quality of RRSOs has significantly improved since our last report. Surgery by a gynaecologic oncologist who informs the pathologist that the woman is at high risk for PSC is associated with optimal RRSO pathology.
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