Ten-year survival after epithelial ovarian cancer is not associated with BRCA mutation status

Kotsopoulos, Joanne; Rosen, Barry P.; Fan, Isabel; Moody, Joel; McLaughlin, John; Risch, Harvey A.; May, Taymaa; Sun, Ping; Narod, Steven A.

doi:10.1016/j.ygyno.2015.11.009

Cited by 101 publications

(99 citation statements)

References 22 publications

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“…Further annual cancer-related death by the mutation status confirmed the findings that the annual risk of death in the mutation carriers was much lower than that of non-carriers in the first two years after diagnosis, but the mortality rate stayed similar or reversed in years 3 to 10. Our findings were consistent with several independent large-scale studies in Caucasians [11,12,16]. For example, in 2013, McLaughlin first reported their long-term follow-up data that short-term survival advantage of BRCA mutations did not provide a long-term survival benefit [12], which led to a controversy on prognostic value of the BRCA mutation status.…”

Section: Discussionsupporting

confidence: 90%

Survival Benefit of Germline BRCA Mutation is Associated with Residual Disease in Ovarian Cancer

Shi

Wang

Tang

et al. 2018

Cell Physiol Biochem

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Background/Aims: Prognostic value of germline BRCA1 or BRCA2 (gBRCA1/2) mutations in epithelial ovarian cancer (EOC) remains controversial, especially in the estimation of long-term survival. We previously reported the largest study of gBRCA1/2 mutation prevalence in Chinese EOC patients. The aim of this study is to further illustrate the correlation of residual disease and survival in BRCA-associated EOC in China. Methods: In the current cohort consisting of 615 cases from the Chinese EOC genome-wide association study, we evaluated the association between gBRCA1/2 mutation and clinical outcomes. Results: Overall, we did not find any significant difference between gBRCA1/2 mutation carriers and non-carriers in both progression-free survival (PFS) and overall survival (OS) (19.3 vs. 18.1 months and 77.2 vs. 73.2 months, P=0.528 and 0.147, HR 0.93 and 0.79, 95%CI 0.74-1.17 and 0.57-1.09, respectively). However, within three years after diagnosis, mutation carriers showed a longer OS than non-carriers (P=0.018, HR 0.53, 95%CI 0.31-0.90). Such a survival advantage decreased along with the extension of follow-up time. Quite interestingly, in the subgroup of patients with gross residual disease, mutation carriers had a longer survival than non-carriers (18.5 vs. 15.1 months and 68.5 vs. 54.3 months, P=0.046 and 0.038, HR 0.74 and 0.65, 95% CI 0.55-1.00 and 0.43-0.98, for PFS and OS respectively). Conclusions: Our findings provided the evidence that gBRCA1/2 mutation was not associated with survival in Chinese EOC patients, which possibly attributed to more than 37% of the patients without gross residual disease. Survival benefit of gBRCA1/2 mutation was prominent in ovarian cancer patients with gross residual disease.

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Section: Discussionsupporting

confidence: 90%

Survival Benefit of Germline BRCA Mutation is Associated with Residual Disease in Ovarian Cancer

Shi

Wang

Tang

et al. 2018

Cell Physiol Biochem

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“…Until levels >1,000, there was a 71% increased risk of disease progression compared to normal levels. Although our data was limited by lack of routine reporting of patient BRCA mutational status, recent data indicates that while BRCA status appears to impact platinum sensitivity and short-term survival, it is not associated with long-term survival [20, 23]. …”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer: an NRG Oncology/Gynecologic Oncology Group ancillary data study

Hamilton

Miller

Casablanca

et al. 2018

Gynecologic Oncology

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Objective To identify clinicopathologic factors associated with 10-year overall survival in epithelial ovarian cancer (EOC) and primary peritoneal cancer (PPC), and to develop a predictive model identifying long-term survivors. Methods Demographic, surgical, and clinicopathologic data were abstracted from GOG 182 records. The association between clinical variables and long-term survival (LTS) (>10 years) was assessed using multivariable regression analysis. Bootstrap methods were used to develop predictive models from known prognostic clinical factors and predictive accuracy was quantified using optimism-adjusted area under the receiver operating characteristic curve (AUC). Results The analysis dataset included 3,010 evaluable patients, of whom 195 survived greater than ten years. These patients were more likely to have better performance status, endometrioid histology, stage III (rather than stage IV) disease, absence of ascites, less extensive preoperative disease distribution, microscopic disease residual following cyoreduction (R0), and decreased complexity of surgery (p<0.01). Multivariable regression analysis revealed that lower CA-125 levels, absence of ascites, stage, and R0 were significant independent predictors of LTS. A predictive model created using these variables had an AUC=0.729, which outperformed any of the individual predictors. Conclusions The absence of ascites, a low CA-125, stage, and R0 at the time of cytoreduction are factors associated with LTS when controlling for other confounders. An extensively annotated clinicopathologic prediction model for LTS fell short of clinical utility suggesting that prognostic molecular profiles are needed to better predict which patients are likely to be long-term survivors.

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“…In a recent study by Kotsopoulos et al, 35 1421 women with OCs were included. After 10 years of follow-up, 57% of BRCA1 mutation carriers and 69% of BRCA2 mutation carriers died from ovarian cancer, and no residual disease at resection was the strongest predictor of long-term survival (P G 0.0001).…”

Section: Discussionmentioning

confidence: 99%

“…After 10 years of follow-up, 57% of BRCA1 mutation carriers and 69% of BRCA2 mutation carriers died from ovarian cancer, and no residual disease at resection was the strongest predictor of long-term survival (P G 0.0001). According to Kotsopoulous et al, 35 the initial survival advantage among women with BRCA mutations may reflect a higher initial sensitivity of BRCA carriers to chemotherapy, but this response does not predict long-term survival. In agreement with this finding, Mclaughlin et al 36 and Candido-dos-Reis et al 37 observed a short-term survival advantage, but not a long-term survival benefit, for BRCA mutation carriers.…”

Section: Discussionmentioning

confidence: 99%

BRCA1, Ki67, and β-Catenin Immunoexpression Is Not Related to Differentiation, Platinum Response, or Prognosis in Women With Low- and High-Grade Serous Ovarian Carcinoma

Sallum¹,

Andrade²,

Costa³

et al. 2018

Int J Gynecol Cancer

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Ki67 expression was significantly higher in HGSOC. BRCA1 and β-catenin expression did not differ between LGSOC and HGSOC samples. BRCA1, Ki67, and β-catenin expression was neither related to clinicopathological features, response to platinum-based chemotherapy, nor survival. Only International Federation of Gynecology and Obstetrics stage remained associated with poor survival in women with HGSOC.

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Ten-year survival after epithelial ovarian cancer is not associated with BRCA mutation status

Cited by 101 publications

References 22 publications

Survival Benefit of Germline BRCA Mutation is Associated with Residual Disease in Ovarian Cancer

Survival Benefit of Germline BRCA Mutation is Associated with Residual Disease in Ovarian Cancer

Clinicopathologic characteristics associated with long-term survival in advanced epithelial ovarian cancer: an NRG Oncology/Gynecologic Oncology Group ancillary data study

BRCA1, Ki67, and β-Catenin Immunoexpression Is Not Related to Differentiation, Platinum Response, or Prognosis in Women With Low- and High-Grade Serous Ovarian Carcinoma

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