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Características clínico-patológicas del cáncer de ovario ligado al BRCA y esporádico
J Boyd1, Y Sonoda, M G Federici
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. boydj@mskcc.org
JAMA
|May 12, 2000
Resumen
Los cánceres hereditarios de ovario vinculados a mutaciones BRCA muestran una patología similar a los tipos esporádicos, pero ofrecen una mejor supervivencia y intervalos más largos libres de enfermedad para las pacientes. La penetración de la edad es mayor para los cánceres vinculados al BRCA1.
Área de la Ciencia:
- Oncología Oncología.
- Genética La genética.
- Oncología Ginecológica Oncología Ginecológica.
Sus antecedentes:
- La mayoría de los cánceres hereditarios de ovario están relacionados con mutaciones de la línea germinal BRCA1 o BRCA2.
- Significado clínico del estado de la mutación BRCA en la supervivencia del cáncer de ovario sigue siendo objeto de debate.
Objetivo del estudio:
- Investigar las características clínicas y patológicas distintas de los cánceres hereditarios de ovario en comparación con los tipos esporádicos.
- Evaluar el impacto del estado de la mutación BRCA en la supervivencia del paciente y la progresión de la enfermedad.
Principales métodos:
- Estudio de cohorte retrospectivo de 933 cánceres de ovario en un centro integral de cáncer.
- Centrarse en pacientes judíos para facilitar el genotipado de BRCA1/BRCA2 (88 hereditarios, 101 esporádicos).
- El análisis incluyó la edad en el diagnóstico, estadio, histología, grado, resultado quirúrgico, respuesta a la quimioterapia y supervivencia.
Principales resultados:
- Cánceres hereditarios diagnosticados a una edad media más joven (54 para BRCA1 frente a 62 para BRCA2; P=.04).
- Histología, grado, estadio y resultados quirúrgicos similares entre casos hereditarios y esporádicos.
- El grupo hereditario mostró un mayor intervalo libre de enfermedad (14 vs. 7 meses; P<.001) y una mejor supervivencia (P=.004).
- El estado de la mutación BRCA fue una variable pronóstica independiente para los cánceres en estadio III (P=.03).
Conclusiones:
- Los cánceres hereditarios de ovario asociados con BRCA comparten rasgos quirúrgicos / patológicos con los cánceres esporádicos.
- Los pacientes con cáncer de ovario hereditario en estadio avanzado demuestran una supervivencia más larga.
- La penetración de la edad es mayor para los cánceres de ovario hereditarios ligados al BRCA1 que para los ligados al BRCA2.
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