Highlights
- •The rate of primary peritoneal carcinoma after diagnosis of isolated STIC is 4.5% in high-risk patients.
- •Adjuvant therapy after diagnosis of isolated STIC may not be warranted.
- •Close surveillance after diagnosis of STIC does not appear of benefit.
Abstract
Objective
Serous tubal intraepithelial carcinoma (STIC) is currently considered the precursor
lesion of pelvic (i.e., ovarian or peritoneal) high-grade serous carcinoma. The incidence
of STIC has been reported to range from 0.6% to 7% in BRCA mutations carriers. However, the clinical outcome of patients with ‘isolated’ STIC
remains elusive. The aim of this study is to review the published literature on isolated
STIC to determine outcomes of these patients and present a summary of management strategies.
Methods
A systematic English-language literature search was conducted in PubMed, MEDLINE-Ovid,
Scopus, EBSCOhost, Cochrane Library of articles published from February 2006 to April
2015. Study inclusion criteria for review were the following: risk-reducing salpingo-oophorectomy
(RRSO), BRCA mutation carriers, non-BRCA mutation carriers, and benign surgical indication. Exclusion criteria were as follows:
the presence of synchronous gynecological cancers, concurrent non-gynecological malignancies,
the presence of ovarian intraepithelial lesions, and articles that did not include
any clinical information and were restricted to pathology information only.
Results
A total of 78 patients with isolated STIC were included in our analysis. The median
age for all patients was 53.7 years (range; 37–83). Surgical indication was RRSO in 67 patients with BRCA mutations or high-risk personal or family history. In the other 11 patients, an incidental
STIC was detected after surgery for non-cancerous indications. Eleven (16.4%) patients
received chemotherapy after the diagnosis of STIC. The follow-up time ranged from
2 to 150 months. Three (4.5%) patients with BRCA mutations were diagnosed with primary peritoneal
carcinoma (PPC) during the follow-up at 43, 48 and 72 months after RRSO.
Conclusions
The rate of primary peritoneal carcinoma in patients with BRCA mutations and isolated STIC is 4.5%. The role of adjuvant therapy remains elusive
and routine surveillance with tumor markers and imaging is not warranted.
Keyword
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Gynecologic OncologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Incidental serous tubal intraepithelial carcinoma and early invasive serous carcinoma in the analysis of a case series.Am. J. Surg. Pathol. 2015; 39: 442-453
- Advances in serous tubal intraepithelial carcinoma: correlation with high grade serous carcinoma and ovarian carcinogenesis.Int. J. Clin. Exp. Pathol. 2014; 7: 848-857
- Clinical outcome of isolated serous tubal intraepithelial carcinomas (STIC).Int. J. Gynecol. Cancer. 2013; 23: 1603-1611
- The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome.Am. J. Surg. Pathol. 2006; 30: 230-236
- Long term follow-up of BRCA1 and BRCA2 mutation carriers with unsuspected neoplasia identified at risk reducing salpingo-oophorectomy.Gynecol. Oncol. 2013; 129: 364-371
- The role of peritoneal cytology at risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of familial ovarian/tubal cancer: is the evidence strong enough?.Gynecol. Oncol. 2013; 128: 148-149
- Outcome of unexpected adnexal neoplasia discovered during risk reduction salpingo-oophorectomy in women with germ-line BRCA1 or BRCA2 mutations.Gynecol. Oncol. 2014; 132: 280-286
- Early detection of high-grade tubal serous carcinoma in women at low risk for hereditary breast and ovarian cancer syndrome by systematic examination of fallopian tubes incidentally removed during benign surgery.Am. J. Surg. Pathol. 2014; 38: 729-742
- Serous tubal intraepithelial carcinoma : an incidental finding at the time of prophylactic bilateral salpingo-oophorectomy.Case Rep. Obstet. Gynecol. 2015; 2015760429
- Clinical and pathologic findings of prophylactic salpingo-oophorectomies in 159 BRCA1 and BRCA2 carriers.Gynecol. Oncol. 2006; 100: 58-64
- Incidental carcinomas in prophylactic specimens in BRCA1 and BRCA2 germ-line mutation carriers, with emphasis on fallopian tube lesions: report of 6 cases and review of the literature.Am. J. Surg. Pathol. 2006; 30: 1222-1230
- Predictors of occult neoplasia in women undergoing risk-reducing salpingo-oophorectomy.Am. J. Obstet. Gynecol. 2006; 194: 1702-1709
- Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction.J. Clin. Oncol. 2007; 25: 3985-3990
- Risk-reducing salpingo-oophorectomy (RRSO) in BRCA mutation carriers: experience with a consecutive series of 111 patients using a standardized surgical–pathological protocol.Int. J. Gynecol. Cancer. 2011; 21: 846-851
- Outcome of risk-reducing salpingo-oophorectomy in BRCA carriers and women of unknown mutation status.BJOG An. Int. J. Obstet. Gynaecol. 2011; 118: 814-824
- Support of the “fallopian tube hypothesis” in a prospective series of risk-reducing salpingo-oophorectomy specimens.Eur. J. Cancer. 2013; 49: 132-141https://doi.org/10.1016/j.ejca.2012.07.021
- Pathologic findings at risk-reducing salpingo-ophorectomy: primary results from Gynecologic Oncology Group Trial GOG-0199.J. Clin. Oncol. 2014; 32: 3275-3283https://doi.org/10.1200/JCO.2013.54.1987
- Origin and molecular pathogenesis of ovarian high-grade serous carcinoma.Ann. Oncol. 2013; 24: ×16-×x21https://doi.org/10.1093/annonc/mdt463
- Utility of peritoneal lavage cytology during laparoscopic salpingo-oophorectomy: a retrospective analysis.BJOG An. Int. J. Obstet. Gynaecol. 2011; 118: 28-33https://doi.org/10.1111/j.1471-0528.2010.02768.x
Article info
Publication history
Published online: September 22, 2015
Accepted:
September 21,
2015
Received in revised form:
September 18,
2015
Received:
August 21,
2015
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
