| Author |
Bolton, Kelly L. Trench, Georgia Chenevix- Goh, Cindy Sadetzki, Siegal Ramus, Susan J. Karlan, Beth Y. Lambrechts, Diether Despierre, Evelyn Barrowdale, Daniel McGuffog, Lesley Healey, Sue Easton, Douglas F. Sinilnikova, Olga Benítez, Javier García, María J. Neuhausen, Susan Gail, Mitchell H. Hartge, Patricia Peock, Susan Frost, Debra Evans, D. Gareth Eeles, Rosalind Godwin, Andrew K. Daly, Mary B. Kwong, Ava Ma, Edmond S. K. Lázaro, Conxi Blanco, Ignacio Montagna, Marco D'Andrea, Emma Nicoletto, Maria Ornella Johnatty, Sharon E. Kjær, Susanne Krüger Jensen, Allan Høgdall, Estrid Goode, Ellen L. Fridley, Brooke L. Loud, Jennifer T. Greene, Mark H. Mai, Phuong L. Chetrit, Angela Lubin, Flora Hirsh-Yechezkel, Galit Glendon, Gord Andrulis, Irene L. Toland, Amanda E. Senter, Leigha Gore, Martin E. Gourley, Charlie Michie, Caroline O. Song, Honglin Tyrer, Jonathan Whittemore, Alice S. McGuire, Valerie Sieh, Weiva Kristoffersson, Ulf Olsson, Håkan Borg, Åke Levine, Douglas A. Steele, Linda Beattie, Mary S. Chan, Salina Nussbaum, Robert L. Moysich, Kirsten B. Gross, Jenny Cass, Ilana Walsh, Christine Li, Andrew J. Leuchter, Ronald Gordon, Ora Garcia-Closas, Montserrat Gayther, Simon A. Chanock, Stephen J. Antoniou, Antonis C. Pharoah, Paul D. P. |
| Abstract |
Context: Approximately 10% of women with invasive epithelial ovarian cancer ( EOC) carry deleterious germline mutations in BRCA1 or BRCA2. A recent article suggested that BRCA2 -related EOC was associated with an improved prognosis, but the effect of BRCA1 remains unclear. Objective: To characterize the survival of BRCA carriers with EOC compared with noncarriers and to determine whether BRCA1 and BRCA2 carriers show similar survival patterns. Design, Setting, and Participants: A pooled analysis of 26 observational studies on the survival of women with ovarian cancer, which included data from 1213 EOC cases with pathogenic germline mutations in BRCA1 (n = 909) or BRCA2 (n = 304) and from 2666 noncarriers recruited and followed up at variable times between 1987 and 2010 (the median year of diagnosis was 1998). Main Outcome Measure: Five-year overall mortality. Results: The 5-year overall survival was 36% (95% CI, 34%-38%) for noncarriers, 44% (95% CI, 40%-48%) for BRCA1 carriers, and 52% (95% CI, 46%-58%) for BRCA2 carriers. After adjusting for study and year of diagnosis, BRCA1 and BRCA2 mutation carriers showed a more favorable survival than noncarriers (for BRCA1: hazard ratio [ HR], 0.78; 95% CI, 0.68-0.89; P < .001; and for BRCA2: HR, 0.61; 95% CI, 0.50-0.76; P < .001). These survival differences remained after additional adjustment for stage, grade, histology, and age at diagnosis (for BRCA1: HR, 0.73; 95% CI, 0.64-0.84; P < .001; and for BRCA2: HR, 0.49; 95% CI, 0.39-0.61; P < .001). The BRCA1 HR estimate was significantly different from the HR estimated in the adjusted model ( P for heterogeneity = .003). Conclusion: Among patients with invasive EOC, having a germline mutation in BRCA1 or BRCA2 was associated with improved 5-year overall survival. BRCA2 carriers had the best prognosis. |
