Gynecologic Oncology

Biography

Biography: Yeh Chen Lee

Abstract

The quality of risk-reducing salpingo-oophorectomy (RRSO) performed in Australasian women was previously reported to be suboptimal. Here we describe the quality of contemporary RRSO in women enrolled in the Kathleen Cuningham Consortium for Research into Familial Breast Cancer (kConFab) and determine if it has improved. Eligible women had high risk of pelvic serous cancer (PSC) and had RRSO between 2008 and 2014. RRSO surgical and pathology reports were reviewed; “adequate” surgery and pathology were defined as complete removal of all ovarian and extra-uterine fallopian tube tissue and paraffin embedding of all removed ovarian and tubal tissue respectively. Associations between clinical factors and “adequate” pathology were assessed using logistic regression. The data were compared with published historical data from the same cohort using Chi-square test. Of 164 eligible women followed for a median of 40 months, 80 and 48 were BRCA1 and BRCA2 mutation carriers respectively. Most RRSOs were performed laparoscopically (74%) by gynaecologic oncologists (58%). 158/159 (99%) had “adequate” surgery and 108/164 (66%) had “adequate” pathology. Independent predictors of “adequate” pathology included surgery by a gynaecologic oncologist rather than a general gynaecologist (p=<0.001), more recent year of surgery (p=0.038), and clinical notes that indicated high risk (p=0.018). Both surgery and pathology were significantly more likely to be “adequate” (p=<0.001) in this contemporary sample. Hence, the quality of RRSO performed in Australasian women has improved dramatically over time. Surgery by a gynaecologic oncologist who informs the pathologist that the woman is at high risk for PSC is associated with optimal RRSO