TY - JOUR
T1 - Salpingectomy With Delayed Oophorectomy Versus Salpingo-Oophorectomy in BRCA1/2 Carriers
T2 - Three-Year Outcomes of a Prospective Preference Trial
AU - Van Bommel, Majke H.D.
AU - Steenbeek, Miranda P.
AU - Inthout, Joanna
AU - Van Garderen, Tessa
AU - Harmsen, Marline G.
AU - Arts-De Jong, Marieke
AU - Maas, Angela H.E.M.
AU - Prins, Judith B.
AU - Bulten, Johan
AU - Van Doorn, Helena C.
AU - Mourits, Marian J.E.
AU - Tros, Rachel
AU - Zweemer, Ronald P.
AU - Gaarenstroom, Katja N.
AU - Slangen, Brigitte F.M.
AU - Brood-Van Zanten, Monique M.A.
AU - Vos, M. Caroline
AU - Piek, Jurgen M.J.
AU - van Lonkhuijzen, Luc R.C.W.
AU - Apperloo, Mirjam J.A.
AU - Coppus, Sjors F.P.J.
AU - Hoogerbrugge, Nicoline
AU - Hermens, Rosella P.M.G.
AU - De Hullu, Joanne A.
N1 - Publisher Copyright:
© 2025 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
PY - 2025/5
Y1 - 2025/5
N2 - Objective: To compare menopause-related quality of life (QoL) after risk-reducing salpingectomy (RRS) versus risk-reducing salpingo-oophorectomy (RRSO) until 3 years of post-surgery. Design: A prospective study (TUBA study) with treatment allocation based on patients' preference. Data were collected pre-surgery and at 3 months, 1 and 3 years of post-surgery. Setting: Multicentre prospective preference trial in thirteen hospitals in the Netherlands. Population: BRCA1/2 pathogenic variant (PV) carriers aged 25–40 (BRCA1) or 25–45 (BRCA2), who were premenopausal, without a future child wish and without current (treatment for) malignancy. Methods: Treatment allocation was based on patients' preference: either RRS from the age of 25 years with delayed oophorectomy at the maximum age of 45 (BRCA1) or 50 (BRCA2), or RRSO between the ages of 35–40 (BRCA1) or 40–45 (BRCA2). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated. Primarily, menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms. Results: Until April 2023, 410 participants had undergone RRS and 160 RRSO. The BRCA1/BRCA2 proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1–6.5; p < 0.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9–9.8) and 8.5 (95% CI 6.5–10.5) points at 3 and 12 months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8–3.9; p = 0.002) point higher increase in GCS-score from baseline compared to the RRS group. Conclusions: In this multicentre preference trial, menopause-related QoL was better after RRS than after RRSO, even with HRT after RRSO. Differences between arms were most pronounced until one-year post-surgery.
AB - Objective: To compare menopause-related quality of life (QoL) after risk-reducing salpingectomy (RRS) versus risk-reducing salpingo-oophorectomy (RRSO) until 3 years of post-surgery. Design: A prospective study (TUBA study) with treatment allocation based on patients' preference. Data were collected pre-surgery and at 3 months, 1 and 3 years of post-surgery. Setting: Multicentre prospective preference trial in thirteen hospitals in the Netherlands. Population: BRCA1/2 pathogenic variant (PV) carriers aged 25–40 (BRCA1) or 25–45 (BRCA2), who were premenopausal, without a future child wish and without current (treatment for) malignancy. Methods: Treatment allocation was based on patients' preference: either RRS from the age of 25 years with delayed oophorectomy at the maximum age of 45 (BRCA1) or 50 (BRCA2), or RRSO between the ages of 35–40 (BRCA1) or 40–45 (BRCA2). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated. Primarily, menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms. Results: Until April 2023, 410 participants had undergone RRS and 160 RRSO. The BRCA1/BRCA2 proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1–6.5; p < 0.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9–9.8) and 8.5 (95% CI 6.5–10.5) points at 3 and 12 months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8–3.9; p = 0.002) point higher increase in GCS-score from baseline compared to the RRS group. Conclusions: In this multicentre preference trial, menopause-related QoL was better after RRS than after RRSO, even with HRT after RRSO. Differences between arms were most pronounced until one-year post-surgery.
KW - BRCA1
KW - BRCA2
KW - delayed oophorectomy
KW - ovarian cancer
KW - quality of life
KW - salpingectomy
KW - salpingo-oophorectomy
UR - http://www.scopus.com/inward/record.url?scp=85215278927&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.18075
DO - 10.1111/1471-0528.18075
M3 - Article
C2 - 39823150
AN - SCOPUS:85215278927
SN - 1470-0328
VL - 132
SP - 782
EP - 794
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 6
ER -