Efficacy of risk-reducing salpingo-oophorectomy in BRCA1–2 variants and clinical outcomes of follow-up in patients with isolated serous tubal intraepithelial carcinoma (STIC)

Serous tubal intraepithelial carcinoma (STIC) is currently considered the precursor lesion of pelvic high-grade serous carcinoma. The management of STIC diagnosed after risk-reducing salpingo-oophorectomy (RRSO) in women with BRCA1–2 variants remains unclear. The aim of our study was to evaluate the incidence of STIC, serous tubal intraepithelial lesions (STIL) and occult invasive cancer (OC) and to determine the long-term outcomes of these patients. We conducted a retrospective study of patients with BRCA 1–2 variants who underwent RRSO between January-2010 and Dicember-2020 at the Clinic of Gynaecology of University of Padova. Inclusion criteria: women with a negative pelvic examination at the last screening prior to RRSO, patients with fallopian tubes analysed using the SEE-FIM protocol. Exclusion criteria: patients with a positive gynaecologic screening or with ovarian/tubal cancer prior to RRSO. We included 153 patients. STICs were diagnosed in 4 patients (2.6%) and STILs in 6 patients (3.9%). None of the patients with STIC underwent restaging surgery or adjuvant chemotherapy; all patients were followed closely every 6 months. None of the patients developed primary peritoneal carcinomas (PPCs) with a median FUP of 54.5 months (15–106). OC was diagnosed in 3 patients (2%). All patients with OC underwent staging surgery, and one patient developed a peritoneal carcinoma (PC) after 18 months by staging surgery. The incidence of STIC, STIL and OC after RRSO in BRCA1–2 variants was low. Our results demonstrated that long-term close surveillance in patients diagnosed with STIC should be considered a possible management strategy. •Approximately 9–24% of cases of epithelial ovarian cancer are due to germline mutations in BRCA1 and BRCA2.•For a woman with BRCA1-2 mutations the risk to develop an ovarian/fallopian tube cancer is 39–46% and 10–27%, respectively.•STIC is currently considered the precursor lesion of pelvic ovarian/peritoneal high-grade serous carcinoma•The rate of PPC after diagnosis of STIC is 4.5-6% in high-risk patients.•The role of subsequent surgery or chemotherapy or strict follow-up to preventing PPC in patients with STIC remains unclear.