Fifteen-year survival of invasive epithelial ovarian cancer in women with BRCA1/2 mutations - the National Israeli Study of Ovarian Cancer
Fifteen-year survival of invasive epithelial ovarian cancer in women with BRCA1/2 mutations - the National Israeli Study of Ovarian Cancer
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DOI：
10.1016/j.ygyno.2019.02.022
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发表时间：
2019-05-01
影响因子：
4.7
通讯作者：
Zoltan, Ahuva
中科院分区：
文献类型：
--
作者：
Lavie, Ofer;Chetrit, Angela;Zoltan, Ahuva
Objective.比较1994 ~ 1999年诊断的非选择性卵巢癌患者中BRCA 1/2基因突变患者与非BRCA 1/2基因突变患者的5、10和15年生存率。该分析基于779名犹太患者：229名携带者在BRCA 1（185 delAG; 5382 insC）和BRCA 2（6174 delT）中的德系犹太创始人突变;和550名非携带者。从患者的病历中提取临床特征，并通过国家人口登记处更新生命状态，直至2015年11月。生存分析采用Kaplan-Meier法、log-rank检验和Cox回归模型。随访期结束时（范围1-20年），发生629例（80.7%）死亡。虽然在诊断后的前5年内，携带者的生存率明显高于非携带者（46.7% vs. 36.2%，p = 0.0004），但15年的生存率分别为22.3% vs. 21.8%（p = 0.04）。在前5年，携带者与非携带者的全因死亡率的年龄调整风险比为0.74（95%CI 0.60-0.91）。对于存活5年和10年的女性，携带者与非携带者相比，在另外5年内死亡率的年龄调整风险比分别为1.38（95%CI 0.93-2.04）和1.08（95%CI 0.61-1.92）。这项研究的结果，长达20年的随访，支持较短的随访研究，表明在前5年中观察到的BRCA 1/2携带者的生存优势随着时间的推移而下降。在临床上，这可能对随访和治疗有影响，特别是对BRCA携带者特别有效的新药物。(C)2019爱思唯尔公司All rights reserved.
Objective. Compare 5, 10 and 15 year survival in invasive epithelial ovarian cancer, between patients with and without BRCA1/2 germ line mutation in a nonselective group of patients diagnosed during 1994-99.Methods. The analysis was based on 779 Jewish patients: 229 carriers to the Ashkenazi Jewish founder mutations in BRCA1 (185delAG; 5382insC) and BRCA2 (6174delT); and 550 non-carriers. Clinical characteristics were abstracted from the patients' medical records and vital status was updated through the National Population Registry up to 11/2015. The Kaplan-Meier method, log-rank tests, and Cox-regression model were used for survival analyses.Results. By the end of the follow-up period, (range 1-20 years), 629 (80.7%) deaths occurred. While considerably higher survival was observed during the first 5 years from diagnosis among carriers compared to non-carriers (46.7% vs. 36.2%, p = 0.0004), the survival rates at 15 years were 22.3% vs. 21.8% respectively (p = 0.04). The age-adjusted hazard ratio for all-cause mortality of carriers versus non-carriers was 0.74 (95%CI 0.60-0.91) in the first 5 years. For women who survived 5 and 10 years, the age-adjusted hazard ratios for mortality during 5 additional years, of carriers compared to non-carriers, were 1.38 (95%CI 0.93-2.04) and 1.08 (95% CI 0.61-1.92), respectively.Conclusion. The results of this study, with up to 20 years follow-up, support studies with shorter follow-up that suggested that the advantage in survival observed among BRCA1/2 carriers during the first 5 years decreases over time. Clinically, this may have implications for follow-up and therapy, especially of new agents that are particularly effective in BRCA carriers. (C) 2019 Elsevier Inc. All rights reserved.