Clinical characteristics and survival outcome of early-stage, high-grade, serous tubo-ovarian carcinoma according to BRCA mutational status

• Published in: Gynecologic oncology 2024-08, Vol.187, p.170-177
• Main Authors: Marchetti, Claudia, Ataseven, Beyhan, Perrone, Anna M., Cassani, Chiara, Fruscio, Robert, Sassu, Carolina M., Apostol, Adriana I., Harter, Philipp, De Iaco, Pierandrea, Camnasio, Cristina Angela, Moubarak, Malak, Giannarelli, Diana, Scambia, Giovanni, Fagotti, Anna
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; BRCA mutation; BRCA1 Protein - genetics; BRCA2 Protein - genetics; Cystadenocarcinoma, Serous - genetics; Cystadenocarcinoma, Serous - mortality; Cystadenocarcinoma, Serous - pathology; Cystadenocarcinoma, Serous - therapy; Early stage; Female; Genes, BRCA1; Genes, BRCA2; Humans; Middle Aged; Mutation; Neoplasm Grading; Neoplasm Recurrence, Local - genetics; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Ovarian cancer; Ovarian Neoplasms - genetics; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Ovarian Neoplasms - therapy; PARP inhibitors; Prognosis; Progression-Free Survival; Retrospective Studies
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2024.05.008

To investigate the role of BRCA1/2 mutations in early ovarian cancer (eOC) (International Federation of Gynecology and Obstetrics FIGO 2014 stage I-II), and its impact on prognosis after relapse. In this multicenter retrospective study, clinical and survival data from high-grade serous (HGS)-eOC patients at presentation and recurrence were compared according to BRCA status: BRCA-mutated (BRCAmut) vs. BRCA wild-type (BRCAwt). Among 191 HGS-eOC patients, 89 were BRCAmut and 102 BRCAwt. There was no significant difference according to the BRCA status in terms of Progression-Free Survival (PFS). A longer Overall Survival (OS) was found in BRCAmut patients. Stage I patients had significantly improved PFS vs stage II, regardless of BRCA status. At multivariate analysis, stage at diagnosis was the only variable with a significant effect on PFS. No factors were significantly relevant on OS, albeit younger age and BRCA mutation showed a slight impact. Post-Recurrence Survival (PRS) in the BRCAmut population was significantly improved compared with BRCAwt. At multivariate analysis, Secondary Cytoreductive Surgery was the strongest predictor for longer PRS, followed by PARPi maintenance at recurrence. BRCA-status is not a prognostic factor in early ovarian cancer regarding PFS. However, our data suggest a better prognosis after relapse in BRCAm population. •Recurrence rate was similar in BRCAwt and BRCAmut groups (35.3% vs 29.2%).•The recurrence patterns were similar between BRCAmut and BRCAwt•BRCA status has no impact on Progression Free Survival.•Post-recurrence Survival was significantly longer in the BRCAmut group.•A longer Overall Survival was found in BRCAmut compared with BRCAwt patients.