Clinical outcomes in patients with isolated serous tubal intraepithelial carcinoma (STIC): A comprehensive review

• Published in: Gynecologic oncology 2015-12, Vol.139 (3), p.568-572
• Main Authors: Patrono, Maria Guadalupe, Iniesta, Maria D, Malpica, Anais, Lu, Karen H, Fernandez, Rodrigo Orozco, Salvo, Gloria, Ramirez, Pedro T
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; BRCA mutation; Breast Neoplasms - genetics; Carcinoma in Situ - epidemiology; Carcinoma in Situ - genetics; Carcinoma in Situ - therapy; Chemotherapy, Adjuvant; Fallopian Tube Neoplasms - epidemiology; Fallopian Tube Neoplasms - genetics; Fallopian Tube Neoplasms - therapy; Female; Genes, BRCA1; Genes, BRCA2; Hematology, Oncology and Palliative Medicine; Humans; Incidence; Mutation; Neoplasms, Cystic, Mucinous, and Serous - epidemiology; Neoplasms, Cystic, Mucinous, and Serous - genetics; Neoplasms, Cystic, Mucinous, and Serous - therapy; Obstetrics and Gynecology; Ovarian Neoplasms - genetics; Ovariectomy; Paclitaxel - administration & dosage; Platinum Compounds - administration & dosage; Risk reducing salpingo-oophorectomy; Salpingectomy; Serous intraepithelial carcinoma; STIC
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2015.09.018

Abstract Objective Serous tubal intraepithelial carcinoma (STIC) is currently considered the precursor lesion of pelvic (i.e., ovarian or peritoneal) high-grade serous carcinoma. The incidence of STIC has been reported to range from 0.6% to 7% in BRCA mutations carriers. However, the clinical outcome of patients with ‘isolated’ STIC remains elusive. The aim of this study is to review the published literature on isolated STIC to determine outcomes of these patients and present a summary of management strategies. Methods A systematic English-language literature search was conducted in PubMed, MEDLINE-Ovid, Scopus, EBSCOhost, Cochrane Library of articles published from February 2006 to April 2015. Study inclusion criteria for review were the following: risk-reducing salpingo-oophorectomy (RRSO), BRCA mutation carriers, non- BRCA mutation carriers, and benign surgical indication. Exclusion criteria were as follows: the presence of synchronous gynecological cancers, concurrent non-gynecological malignancies, the presence of ovarian intraepithelial lesions, and articles that did not include any clinical information and were restricted to pathology information only. Results A total of 78 patients with isolated STIC were included in our analysis. The median age for all patients was 53.7 years (range; 37–83). Surgical indication was RRSO in 67 patients with BRCA mutations or high-risk personal or family history. In the other 11 patients, an incidental STIC was detected after surgery for non-cancerous indications. Eleven (16.4%) patients received chemotherapy after the diagnosis of STIC. The follow-up time ranged from 2 to 150 months. Three (4.5%) patients with BRCA mutations were diagnosed with primary peritoneal carcinoma (PPC) during the follow-up at 43, 48 and 72 months after RRSO. Conclusions The rate of primary peritoneal carcinoma in patients with BRCA mutations and isolated STIC is 4.5%. The role of adjuvant therapy remains elusive and routine surveillance with tumor markers and imaging is not warranted.