Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3872
Peer-review started: July 12, 2019
First decision: September 9, 2019
Revised: September 19, 2019
Accepted: October 5, 2019
Article in press: October 5, 2019
Published online: November 26, 2019
Primary peritoneal cancer (PPC) patients with BRCA mutations have a good prognosis; however, for patients with BRCA mutations who are diagnosed with PPC after prophylactic salpingo-oophorectomy (PSO), the prognosis is poor, and survival information is scarce.
We treated a 56-year-old woman with PPC after bilateral mastectomy, hysterectomy, and bilateral salpingo-oophorectomy. This patient had primary drug resistance and died 12 mo after the diagnosis of PPC. The genetic test performed on this patient indicated the presence of a germline BRCA1 mutation. We searched the PubMed, Scopus, and Cochrane databases and extracted studies of patients with BRCA mutations who developed PPC after PSO. After a detailed literature search, we found 30 cases, 7 of which had a history of breast cancer, 14 of which had no history of breast cancer, and 9 of which had an unknown history. The average age of PSO patients was 48.86 years old (range, 31-64 years). The average time interval between the diagnosis of PPC and preventive surgery was 61.03 mo (range, 12-292 mo). The 2-year survival rate for this patient population was 78.26% (18/23), the 3-year survival rate was 50.00% (9/18), and the 5-year survival rate was 6.25% (1/16).
Patients with BRCA mutations who are diagnosed with PPC after preventative surgery have a poor prognosis. Prevention measures and treatments for these patients need more attention.
Core tip: To the best of our knowledge, this is the first article to describe the survival and prognosis of primary peritoneal cancer (PPC) after prophylactic salpingo-oophorectomy (PSO) in patients with hereditary breast and ovarian cancer. Previous studies have shown that PPC patients with BRCA mutations have better therapeutic outcomes and prognosis, but the patient we reported showed primary resistance to initial treatment and only survived for 12 mo. We found that the 3-year survival rate was 50.00% (9/18) and the 5-year survival rate was only 6.25% (1/16) for patients with PPC after PSO, which is different from our previous perceptions, and these results are surprising.