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Cancer Prev Res (Phila). 2018 Nov;11(11):697-706. doi: 10.1158/1940-6207.CAPR-18-0009. Epub 2018 Sep 19.

Fallopian Tube Lesions in Women at High Risk for Ovarian Cancer: A Multicenter Study.

Author information

1
Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA. kvisvan1@jhu.edu.
2
Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
3
Department of Pathology, University Health Network, Toronto, Ontario, Canada.
4
Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA.
5
Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
6
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
7
Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
8
Department of Pathology, Johns Hopkins University School of Medicine.
9
Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
10
Perlmutter Cancer Center, New York University Langone Medical Center, New York, NY, USA.
11
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Abstract

The prognosis of women diagnosed with invasive high-grade serous ovarian carcinoma (HGSC) is poor. More information about serous tubal intraepithelial carcinoma (STIC) and serous tubal intraepithelial lesions (STIL), putative precursor lesions of HGSC, could inform prevention efforts. We conducted a multicenter study to identify risk/protective factors associated with STIC/STILs and characterize p53 signatures in the fallopian tube. The fallopian tubes and ovaries of 479 high-risk women ≥30 years of age who underwent bilateral risk-reducing salpingo-oophorectomy were reviewed for invasive cancer/STICs/STILs. Epidemiologic data was available for 400 of these women. In 105 women, extensive sampling of the tubes for STICs/STILs/p53 signatures were undertaken. Descriptive statistics were used to compare groups with and without lesions. The combined prevalence of unique tubal lesions [invasive serous cancer (n = 6) /STICs (n = 14)/STILs (n = 5)] was 6.3% and this was split equally among BRCA1 (3.0%) and BRCA2 mutation carriers (3.3%). A diagnosis of invasive cancer was associated with older age but no risk/protective factor was significantly associated with STICs/STILs. Extensive sampling identified double the number of STICs/STILs (11.9%), many p53 signatures (27.0%), and multiple lesions in 50% of the cases. Women with p53 signatures in the fimbria were older than women with signatures in the remaining tube (P = 0.03). STICs/STILs may not share the protective factors that are associated with HGSC. It is plausible that these factors are only associated with STICs that progress to HGSC. Having multiple lesions in the fimbria may be an important predictor of disease progression. Cancer Prev Res; 11(11); 697-706. ©2018 AACR.

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