Majke H. D. Van Bommel, Miranda P. Steenbeek, Joanna Inthout, Tessa Van Garderen, Marline G. Harmsen, Marieke Arts-De Jong, Angela H. E. M. Maas, Judith B. Prins, Johan Bulten, Helena C. Van Doorn, Marian J. E. Mourits, Rachel Tros, Ronald P. Zweemer, Katja N. Gaarenstroom, Brigitte F. M. Slangen, Monique M. A. Brood-Van Zanten, M. Caroline Vos, Jurgen M. J. Piek, Luc R. C. W. van Lonkhuijzen, Mirjam J. A. Apperloo, Sjors F. P. J. Coppus, Nicoline Hoogerbrugge, Rosella P. M. G. Hermens, Joanne A. De Hullu
{"title":"BRCA1/2携带者输卵管切除术加延迟卵巢切除术与输卵管-卵巢切除术：一项前瞻性偏好试验的三年结果","authors":"Majke H. D. Van Bommel, Miranda P. Steenbeek, Joanna Inthout, Tessa Van Garderen, Marline G. Harmsen, Marieke Arts-De Jong, Angela H. E. M. Maas, Judith B. Prins, Johan Bulten, Helena C. Van Doorn, Marian J. E. Mourits, Rachel Tros, Ronald P. Zweemer, Katja N. Gaarenstroom, Brigitte F. M. Slangen, Monique M. A. Brood-Van Zanten, M. Caroline Vos, Jurgen M. J. Piek, Luc R. C. W. van Lonkhuijzen, Mirjam J. A. Apperloo, Sjors F. P. J. Coppus, Nicoline Hoogerbrugge, Rosella P. M. G. Hermens, Joanne A. De Hullu","doi":"10.1111/1471-0528.18075","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To compare menopause-related quality of life (QoL) after risk-reducing salpingectomy (RRS) versus risk-reducing salpingo-oophorectomy (RRSO) until 3 years of post-surgery.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>A prospective study (TUBA study) with treatment allocation based on patients' preference. Data were collected pre-surgery and at 3 months, 1 and 3 years of post-surgery.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Multicentre prospective preference trial in thirteen hospitals in the Netherlands.</p>\n </section>\n \n <section>\n \n <h3> Population</h3>\n \n <p>\n <i>BRCA1/2</i> pathogenic variant (PV) carriers aged 25–40 (<i>BRCA1</i>) or 25–45 (<i>BRCA2</i>), who were premenopausal, without a future child wish and without current (treatment for) malignancy.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Treatment allocation was based on patients' preference: either RRS from the age of 25 years with delayed oophorectomy at the maximum age of 45 (<i>BRCA1</i>) or 50 (<i>BRCA2</i>), or RRSO between the ages of 35–40 (<i>BRCA1</i>) or 40–45 (<i>BRCA2</i>). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated. Primarily, menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Until April 2023, 410 participants had undergone RRS and 160 RRSO. The <i>BRCA1/BRCA2</i> proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1–6.5; <i>p</i> < 0.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9–9.8) and 8.5 (95% CI 6.5–10.5) points at 3 and 12 months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8–3.9; <i>p =</i> 0.002) point higher increase in GCS-score from baseline compared to the RRS group.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>In this multicentre preference trial, menopause-related QoL was better after RRS than after RRSO, even with HRT after RRSO. Differences between arms were most pronounced until one-year post-surgery.</p>\n </section>\n </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"782-794"},"PeriodicalIF":4.7000,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18075","citationCount":"0","resultStr":"{\"title\":\"Salpingectomy With Delayed Oophorectomy Versus Salpingo-Oophorectomy in BRCA1/2 Carriers: Three-Year Outcomes of a Prospective Preference Trial\",\"authors\":\"Majke H. D. Van Bommel, Miranda P. Steenbeek, Joanna Inthout, Tessa Van Garderen, Marline G. Harmsen, Marieke Arts-De Jong, Angela H. E. M. Maas, Judith B. Prins, Johan Bulten, Helena C. Van Doorn, Marian J. E. Mourits, Rachel Tros, Ronald P. Zweemer, Katja N. Gaarenstroom, Brigitte F. M. Slangen, Monique M. A. Brood-Van Zanten, M. Caroline Vos, Jurgen M. J. Piek, Luc R. C. W. van Lonkhuijzen, Mirjam J. A. Apperloo, Sjors F. P. J. Coppus, Nicoline Hoogerbrugge, Rosella P. M. G. Hermens, Joanne A. De Hullu\",\"doi\":\"10.1111/1471-0528.18075\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To compare menopause-related quality of life (QoL) after risk-reducing salpingectomy (RRS) versus risk-reducing salpingo-oophorectomy (RRSO) until 3 years of post-surgery.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>A prospective study (TUBA study) with treatment allocation based on patients' preference. 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Primarily, menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Until April 2023, 410 participants had undergone RRS and 160 RRSO. The <i>BRCA1/BRCA2</i> proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1–6.5; <i>p</i> < 0.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9–9.8) and 8.5 (95% CI 6.5–10.5) points at 3 and 12 months, respectively. 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Salpingectomy With Delayed Oophorectomy Versus Salpingo-Oophorectomy in BRCA1/2 Carriers: Three-Year Outcomes of a Prospective Preference Trial
Objective
To compare menopause-related quality of life (QoL) after risk-reducing salpingectomy (RRS) versus risk-reducing salpingo-oophorectomy (RRSO) until 3 years of post-surgery.
Design
A prospective study (TUBA study) with treatment allocation based on patients' preference. Data were collected pre-surgery and at 3 months, 1 and 3 years of post-surgery.
Setting
Multicentre prospective preference trial in thirteen hospitals in the Netherlands.
Population
BRCA1/2 pathogenic variant (PV) carriers aged 25–40 (BRCA1) or 25–45 (BRCA2), who were premenopausal, without a future child wish and without current (treatment for) malignancy.
Methods
Treatment allocation was based on patients' preference: either RRS from the age of 25 years with delayed oophorectomy at the maximum age of 45 (BRCA1) or 50 (BRCA2), or RRSO between the ages of 35–40 (BRCA1) or 40–45 (BRCA2). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated. Primarily, menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms.
Results
Until April 2023, 410 participants had undergone RRS and 160 RRSO. The BRCA1/BRCA2 proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1–6.5; p < 0.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9–9.8) and 8.5 (95% CI 6.5–10.5) points at 3 and 12 months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8–3.9; p = 0.002) point higher increase in GCS-score from baseline compared to the RRS group.
Conclusions
In this multicentre preference trial, menopause-related QoL was better after RRS than after RRSO, even with HRT after RRSO. Differences between arms were most pronounced until one-year post-surgery.
期刊介绍：
BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.
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