Cancer Risk-Reducing Opportunities in Gynecologic Surgery

Piszczek, C.; Ma, Jun; Gould, Claire; Tseng, Paul C.

doi:10.1016/j.jmig.2017.10.025

Cited by 4 publications

(3 citation statements)

References 112 publications

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“…Large prospective studies have demonstrated that the use of hormone replacement therapy (HRT) in premature surgical menopause improves many of these adverse health effects and reduces all-cause mortality [3].…”

mentioning

confidence: 99%

Hormone Replacement Therapy Prescription after Premature Surgical Menopause

Garg

Behbehani

Kosiorek

et al. 2020

Journal of Minimally Invasive Gynecology

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Study Objective: To assess hormone replacement therapy (HRT) prescription pattern in patients undergoing premature surgical menopause on the basis of surgical indication. Design: Retrospective cohort study. Setting: Academic tertiary care center. Patients: Surgically menopausal patients aged ≤45 years who underwent a minimally invasive hysterectomy with salpingooophorectomy. Interventions: HRT prescription in the 6-week postoperative period. Measurements and Main Results: A total of 63 patients met inclusion criteria. Of these, 52% (n = 33) were prescribed HRT in the 6-week postoperative period. Indications for surgical menopause included pelvic pain or endometriosis (31.7%), gynecologic malignancy (20.6%), BRCA gene mutation (17.4%), breast cancer (9.5%), Lynch syndrome (4.8%), and other (15.8%). In total, 80% of patients with pelvic pain, 25% with gynecologic malignancies, 45% with BRCA gene mutations, 33.3% with breast cancer, and 66.6% with Lynch syndrome used HRT postoperatively. In patients who used HRT postoperatively, 76% were offered preoperative HRT counseling. This is in contrast with those patients who did not use HRT postoperatively, of whom only 33% were offered HRT counseling (p <.001). Perioperative complications were not predictive of HRT use postoperatively. In patients who did not use HRT postoperatively, 13.3% used alternative nonhormonal therapy. Conclusion: In patients who underwent premature surgical menopause, 52% used HRT postoperatively. Patients with pelvic pain and Lynch syndrome were more likely to use HRT, whereas those with gynecologic or breast malignancies and BRCA gene mutations were less likely to use HRT. Preoperative HRT counseling was associated with postoperative HRT use.

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mentioning

confidence: 99%

Hormone Replacement Therapy Prescription after Premature Surgical Menopause

Garg

Behbehani

Kosiorek

et al. 2020

Journal of Minimally Invasive Gynecology

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“…A number of studies examined the risk of serous-type uterine cancer among individuals with the BRCA1 mutation, some of which showed a small association. 8,[67][68][69][70][71] The National Comprehensive Cancer Network states that this association may reflect tamoxifen use rather than genetic predisposition. 68 A family history of endometrial cancer without known familial gene mutations is associated with an increased risk in first-degree relatives (RR 1.82, 95% CI 1.65-1.98).…”

Section: Family History and Genetic Syndromesmentioning

confidence: 99%

“…Lynch Syndrome Based on expert opinion, hysterectomy should be considered for risk reduction for women with Lynch syndrome who have completed childbearing. 66,69,94,95 Hysterectomy significantly reduces endometrial cancer incidence but not mortality in women with Lynch syndrome. 66,96 The National Comprehensive Cancer Network recommends considering risk-reducing hysterectomy for Lynch syndrome patients, with timing, "individualized based on whether childbearing is complete, comorbidities, family history, and [Lynch syndrome] gene, as risks for endometrial cancer vary by pathogenic variant."…”

Section: Special Populationsmentioning

confidence: 99%

Executive Summary of the Uterine Cancer Evidence Review Conference

Chelmow

Brooks

Cavens

et al. 2022

Obstetrics &Amp; Gynecology

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receives a stipend as the editor-in-chief of the Medscape Obstetrics and Gynecology Clinical Reference Book, and was on the American Board of Obstetrics and Gynecology Board of Directors during the evidence review and manuscript writing period. David Chelmow is a member of the United States Preventive Services Task Force (USPSTF). This article does not necessarily represent the views and policies of the USPSTF. Rebecca Brooks is a member of an AstraZeneca speakers' bureau related to ovarian cancer, a past advisory board member and consultant for GSK and Merck & Co., Inc., and a past non-branded speaker for Clinical Care Options. Sangini Sheth is a past consultant for Merck & Co., Inc., and a research study grant recipient (drug only: HPV vaccine) from Merck & Co., Inc. She was paid costs of travel and meeting registration (paid directly) and received honoraria payment for an education course from the ASCCP. She also has research grants from the NIH and CDC for studies unrelated to the submitted work.

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