The role of peritoneal cytology at risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of familial ovarian/tubal cancer

Manchanda, Ranjit; Drapkin, Ronny; Jacobs, Ian; Menon, Usha

doi:10.1016/j.ygyno.2011.10.017

Cited by 25 publications

(21 citation statements)

References 27 publications

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“…For example, BRCA mutation was an inclusion criteria for most but not all of the prior reports; for some, high-risk personal and family history was sufficient for inclusion. 11,16,17,19,20,24 As demonstrated by Manchanda et al, the risk of an occult lesion is lower among patients without documented BRCA mutation. In this series, no patients known to be BRCA negative were found to have a STIC lesion.…”

Section: Discussionmentioning

confidence: 89%

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Clinical Outcome of Isolated Serous Tubal Intraepithelial Carcinomas (STIC)

Wethington¹,

Park²,

Soslow³

et al. 2013

Int J Gynecol Cancer

102

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Objective Risk-reducing salpingo-oophorectomy (RRSO) is recommended for women with BRCA mutation due to increased risk of pelvic serous carcinoma. Serous tubal intraepithelial carcinoma (STIC) is a pathologic finding of unknown clinical significance. This study evaluates the clinical outcome of patients with isolated STIC. Materials/Methods We retrospectively reviewed the medical records of consecutive patients with a germline BRCA1/2 mutation or a high-risk personal or family history of ovarian cancer who underwent RRSO between January 2006 and June 2011. All patients had peritoneal washings collected. All surgical specimens were assessed using the sectioning and extensively examining the fimbria protocol, with immunohistochemistry when indicated. p53 signature lesions and secretory cell outgrowths were excluded. Results Of 593 patients who underwent RRSO, isolated STIC was diagnosed in 12 patients (2%). Five patients (42%)were BRCA1 positive, 5 patients (42%)were BRCA2 positive, and 2 patients (17%) had high-risk family history. Preoperatively, all patients with STIC had normal CA-125 levels and/or pelvic imaging results. Seven patients underwent hysterectomy and omentectomy, 6 patients (46%) had pelvic node dissections, and 5 patients (39%) had para-aortic node dissections. With the exception of positive peritoneal washings in 1 patient, no invasive or metastatic disease was identified. No patient received adjuvant chemotherapy. At median follow-up of 28 months (range, 16–44 months), no recurrences have been identified. Conclusions Among the cases of isolated STIC after RRSO reported in the literature, the yield of surgical staging is low, and short-term clinical outcomes are favorable. Peritoneal washings are the most common site of disease spread. Individualized management is warranted until additional data become available.

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Section: Discussionmentioning

confidence: 89%

“…After her diagnosis of PPC, the RRSO specimen was retrospectively examined with a more detailed sectioning and revealed a single focus of STIC. 20 The second patient is the only person who has developed PPC after diagnosis of an isolated STIC at the time of RRSO. She was 49 at the time of RRSO.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Isolated Serous Tubal Intraepithelial Carcinomas (STIC)

Wethington¹,

Park²,

Soslow³

et al. 2013

Int J Gynecol Cancer

102

View full text Add to dashboard Cite

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“…The high incidence of positive washings found in association with STIC has led to the recommendation that peritoneal washings be performed routinely at RRSO in high-risk patients, 49 because it may provide important prognostic information. 50 Patrono 34 recently published that the incidence of primary peritoneal cancer in patients with isolated STIC and a known BRCA mutation is 4.5%. Therefore, these patients are high risk and necessitate continued surveillance.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Characteristics of Unsuspected Neoplasia Discovered in High-Risk Women Undergoing Risk Reductive Bilateral Salpingooophorectomy

Poon

Hyde²,

Grant³

et al. 2016

Int J Gynecol Cancer

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“…Cytological diagnosis of this malignancy is difficult because of the technical problems, including sampling of fallopian tube epithelium. In general, this malignancy thus could be diagnosed by cervical [22] [23], vaginal [24], endometrial [25] or peritoneal [26] cytology. Cytology obtained by hydrotubation could be useful for diagnosing adenocarcinoma in situ of the fallopian tube [27].…”

Section: Discussionmentioning

confidence: 99%

A Case of Serous Tubal Intraepithelial Carcinoma Diagnosed by Cytology during the Operation

Niwa¹,

Ishihara²,

Ueda³

et al. 2018

OJPathology

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We experienced a case of serous tubal intraepithelial carcinoma (STIC), which is the earliest morphologically recognizable precursor of pelvic high grade serous carcinoma, diagnosed by cytology during the operation. A 48-year-old Japanese woman visited to our department because of abnormal cytological result and the left adnexal mass on female cancer screening. Pre-operatively, she was diagnosed as cervical intraepithelial neoplasia (CIN) 3, adenomyosis, and the left adnexal cystic lesion with papillary growth. At laparotomy, the left adnexal tumor turned out to be cystic fallopian tube with small papillary growth on the inner surface, but abnormal findings were not present on bilateral ovaries. The cytology of the imprint smears from the papillary projection and ascitic fluid showed positive, suggesting serous adenocarcinoma. Histopathological examination of the lesion revealed the left fallopian tube lesion was STIC with immunohistochemically positive reactivity against p53. No metastases including disseminated lesions were noted. The patient received four courses of systemic chemotherapy, and had no recurrent signs 10 months after the operation.

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The role of peritoneal cytology at risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of familial ovarian/tubal cancer

Cited by 25 publications

References 27 publications

Clinical Outcome of Isolated Serous Tubal Intraepithelial Carcinomas (STIC)

Clinical Outcome of Isolated Serous Tubal Intraepithelial Carcinomas (STIC)

Incidence and Characteristics of Unsuspected Neoplasia Discovered in High-Risk Women Undergoing Risk Reductive Bilateral Salpingooophorectomy

A Case of Serous Tubal Intraepithelial Carcinoma Diagnosed by Cytology during the Operation

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