Risk-Reducing Gynecological Surgery in Lynch Syndrome: Results of an International Survey from the Prospective Lynch Syndrome Database

被引：15

作者：

Dominguez-Valentin, Mev ^{[1
]}

Seppala, Toni T. ^{[2
,3
]}

Engel, Christoph ^{[4
]}

Aretz, Stefan ^{[5
,6
]}

Macrae, Finlay ^{[7
,8
]}

Winship, Ingrid ^{[7
,8
]}

Capella, Gabriel ^{[9
,10
]}

Thomas, Huw ^{[11
]}

Hovig, Eivind ^{[1
,12
]}

Nielsen, Maartje ^{[13
]}

Sijmons, Rolf H. ^{[14
]}

Bertario, Lucio ^{[15
]}

Bonanni, Bernardo ^{[16
]}

Tibiletti, Maria Grazia ^{[17
]}

Cavestro, Giulia Martina ^{[18
]}

Mints, Miriam ^{[19
]}

Gluck, Nathan ^{[20
,21
]}

Katz, Lior ^{[22
]}

Heinimann, Karl ^{[23
]}

Vaccaro, Carlos A. ^{[24
]}

Green, Kate ^{[25
,26
]}

Lalloo, Fiona ^{[25
,26
]}

Hill, James ^{[25
,27
]}

Schmiegel, Wolff ^{[28
]}

Vangala, Deepak ^{[29
]}

Perne, Claudia ^{[5
,6
]}

Strauss, Hans-Georg ^{[30
]}

Tecklenburg, Johanna ^{[31
]}

Holinski-Feder, Elke ^{[32
,33
]}

Steinke-Lange, Verena ^{[32
,33
]}

Mecklin, Jukka-Pekka ^{[34
,35
]}

Plazzer, John-Paul ^{[7
]}

Pineda, Marta ^{[9
,10
]}

Navarro, Matilde ^{[9
,10
]}

Vidal, Joan Brunet ^{[9
,10
]}

Kariv, Revital ^{[20
,21
]}

Rosner, Guy ^{[20
,21
]}

Alejandra Pinero, Tamara ^{[24
]}

Laura Gonzalez, Maria ^{[24
]}

Kalfayan, Pablo ^{[24
]}

Sampson, Julian R. ^{[36
]}

Ryan, Neil A. J. ^{[25
,26
]}

Evans, D. Gareth ^{[25
,26
]}

Moller, Pal ^{[1
]}

Crosbie, Emma J. ^{[25
,26
]}

机构：

[1] Norwegian Radium Hosp, Inst Canc Res, Dept Tumor Biol, N-0379 Oslo, Norway

[2] Univ Helsinki, Dept Abdominal Surg, Cent Hosp, Helsinki 00029, Finland

[3] Univ Helsinki, Fac Med, Helsinki 00014, Finland

[4] Univ Leipzig, Inst Med Informat Stat & Epidemiol, D-04107 Leipzig, Germany

[5] Univ Bonn, Inst Human Genet, D-53127 Bonn, Germany

[6] Univ Hosp Bonn, Ctr Hereditary Tumor Syndromes, D-53127 Bonn, Germany

[7] Royal Melbourne Hosp, Colorectal Med & Genet, Melbourne, Vic 3052, Australia

[8] Univ Melbourne, Dept Med, Melbourne, Vic 3052, Australia

[9] Inst Invest Biomed Bellvitge IDIBELL, Catalan Inst Oncol, Hereditary Canc Program, ONCOBELL Program, Barcelona 08908, Spain

[10] Ctr Invest Biomed Red Canc CIBERONC, Madrid 28029, Spain

[11] Imperial Coll London, Dept Surg & Canc, St Marks Hosp, London HA1 3UJ, England

[12] Univ Oslo, Ctr Bioinformat, Dept Informat, N-0316 Oslo, Norway

[13] Leids Univ, Med Ctr, Dept Clin Genet, NL-2300 RC Leiden, Netherlands

[14] Univ Groningen, Univ Med Ctr Groningen, Dept Genet, NL-9713 GZ Groningen, Netherlands

[15] Fdn IRCCS Ist Nazl Tumori, European Inst Oncol, Div Prevent & Genet Oncol, I-20141 Milan, Italy

[16] European Inst Oncol, Div Prevent & Genet Oncol, I-20141 Milan, Italy

[17] Univ Insubria, Osped Circolo ASST Settelaghi, Ctr Ric Tumori Eredo Familiari, I-21100 Varese, Italy

[18] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Gastroenterol & Gastrointestinal Endoscopy Unit, I-20132 Milan, Italy

[19] Karolinska Inst, S-17176 Stockholm, Sweden

[20] Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, Dept Gastroenterol, IL-64239 Tel Aviv, Israel

[21] Tel Aviv Univ, Sackler Fac Med, IL-64239 Tel Aviv, Israel

[22] Hadassah Med Ctr, Dept Gastroenterol & Hepatol, IL-91120 Jerusalem, Israel

[23] Univ Hosp Basel, Inst Med Genet & Pathol, Med Genet, CH-4031 Basel, Switzerland

[24] Hosp Italiano Buenos Aires, Hereditary Canc Program PROCANHE, C1199ABB, Buenos Aires, DF, Argentina

[25] Univ Manchester, Manchester M13 9WL, Lancs, England

[26] Manchester Univ NHS Fdn Trust, Manchester M13 9WL, Lancs, England

[27] Manchester Univ NHS Fdn Trust, Dept Surg, Manchester M13 9WL, Lancs, England

[28] Ruhr Univ Bochum, Dept Med, Knappschaftskrankenhaus, D-44801 Bochum, Germany

[29] Ruhr Univ Bochum, Dept Med, Knappschaftskrankenhaus, D-44892 Bochum, Germany

[30] Martin Luther Univ Halle Wittenberg, Univ Clin, Dept Gynecol, D-06097 Halle, Saale, Germany

[31] Hannover Med Sch, Inst Human Genet, D-30625 Hannover, Germany

[32] Klinikum Univ Munchen, Med Klin & Poliklin 4, Campus Innenstadt, D-80336 Munich, Germany

[33] MGZ Med Genet Ctr, D-80335 Munich, Germany

[34] Univ Jyvaskyla, Fac Sport & Hlth Sci, Jyvaskyla 40014, Finland

[35] Cent Finland Hlth Care Dist, Dept Surg, Jyvaskyla 40620, Finland

[36] Cardiff Univ, Sch Med, Div Canc & Genet, Inst Med Genet, Cardiff CF14 4XN, Wales

来源：

JOURNAL OF CLINICAL MEDICINE | 2020年 / 9卷 / 07期

关键词：

Lynch syndrome; endometrial cancer; ovarian cancer; risk-reducing surgery; HORMONE REPLACEMENT THERAPY; COLORECTAL-CANCER; HEALTH; ESTROGEN;

D O I：

10.3390/jcm9072290

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose: To survey risk-reducing hysterectomy and bilateral salpingo-oophorectomy (BSO) practice and advice regarding hormone replacement therapy (HRT) in women with Lynch syndrome. Methods: We conducted a survey in 31 contributing centers from the Prospective Lynch Syndrome Database (PLSD), which incorporates 18 countries worldwide. The survey covered local policies for risk-reducing hysterectomy and BSO in Lynch syndrome, the timing when these measures are offered, the involvement of stakeholders and advice regarding HRT. Results: Risk-reducing hysterectomy and BSO are offered to path_MLH1 and path_MSH2 carriers in 20/21 (95%) contributing centers, to path_MSH6 carriers in 19/21 (91%) and to path_PMS2 carriers in 14/21 (67%). Regarding the involvement of stakeholders, there is global agreement (similar to 90%) that risk-reducing surgery should be offered to women, and that this discussion may involve gynecologists, genetic counselors and/or medical geneticists. Prescription of estrogen-only HRT is offered by 15/21 (71%) centers to women of variable age range (35-55 years). Conclusions: Most centers offer risk-reducing gynecological surgery to carriers of path_MLH1, path_MSH2 and path_MSH6 variants but less so for path_PMS2 carriers. There is wide variation in how, when and to whom this is offered. The Manchester International Consensus Group developed recommendations to harmonize clinical practice across centers, but there is a clear need for more research.

引用

页码：1 / 8

页数：8

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