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2. Deep learning detects premalignant lesions in the Fallopian tube

Author

Bogaerts, Joep M. A., Bokhorst, John-Melle, Simons, Michiel, van Bommel, Majke H. D., Steenbeek, Miranda P., de Hullu, Joanne A., Linmans, Jasper, Bart, Joost, Bentz, Jessica L., Bosse, Tjalling, Bulten, Johan, Chien, Yen-Wei, Desouki, Mohamed Mokhtar, Lastra, Ricardo R., Numan, Tricia A., Schoolmeester, J. Kenneth, Schwartz, Lauren E., Shih, Ie-Ming, Soong, T. Rinda, Turashvili, Gulisa, Vang, Russell, Volchek, Mila, and van der Laak, Jeroen A. W. M.

Published
2024
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3. Vulvar cancer and vulvar premalignancies

Author

de Hullu, Joanne A., van der Avoort, Irene A. M., Oonk, Maaike H. M., van Poelgeest, Mariette I. E., Steegers, Eric A.P., editor, de Groot, Christianne J.M., editor, Hilders, Carina G.J.M., editor, Hoek, Annemieke, editor, Jaddoe, Vincent W.V., editor, Schoenmakers, Sam, editor, and Zweemer, Ronald P., editor

Published
2024
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5. Coronary Artery Calcium Scores After Prophylactic Premenopausal Bilateral Salpingo-Oophorectomy

Author

Beekman, Maarten J., Terra, Lara, Heemskerk-Gerritsen, Bernadette A.M., van der Aalst, Carlijn M., Roeters van Lennep, Jeanine E., van Beurden, Marc, van Doorn, Helena C., de Hullu, Joanne A., van Dorst, Eleonora B.L., Mom, Constantijne H., Mourits, Marian J.E., Slangen, Brigitte F.M., Bartels-Rutten, Annemarieke, Budde, Ricardo P.J., Snoeren, Miranda M., Leiner, Tim, de Jong, Pim A., Vliegenthart, Rozemarijn, Planken, R. Nils, Mihl, Casper, Vonder, Marleen, Oudkerk, Matthijs, Gaarenstroom, Katja N., Gratama, Jan Willem C., van Engelen, Klaartje, van der Kolk, Lizet E., Collée, J. Margriet, Wevers, Marijke R., Ausems, Margreet G.E.M., Berger, Lieke P.V., Gomez Garcia, Encarna B., van Asperen, Christi J., Hooning, Maartje J., de Koning, Harry J., Maas, Angela H.E.M., and van Leeuwen, Flora E.

Published
2024
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6. Long-term outcome of high-grade serous carcinoma established in risk-reducing salpingo-oophorectomy specimens in asymptomatic BRCA1/2 germline pathogenic variant carriers

Author

Stroot, Iris A.S., Bart, Joost, Hollema, Harry, Jalving, Mathilde, Wagner, Marise M., Yigit, Refika, van Doorn, Helena C., de Hullu, Joanne A., Gaarenstroom, Katja N., van Beurden, Marc, van Lonkhuijzen, Luc R.C.W., Slangen, Brigitte F.M., Zweemer, Ronald P., Gómez García, Encarna B., Ausems, Margreet G.E.M., Boere, Ingrid A., van Hest, Liselotte P., Duijkers, Floor A.M., van Asperen, Christi J., Schmidt, Marjanka K., Wevers, Marijke R., Ruijs, Marielle W.G., Devilee, Peter, Collée, J. Margriet, HEBON investigators, de Bock, Geertruida H., and Mourits, Marian J.E.

Published
2024
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7. Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II

Author

Oonk, Maaike HM, Slomovitz, Brian, Baldwin, Peter JW, van Doorn, Helena C, van der Velden, Jacobus, de Hullu, Joanne A, Gaarenstroom, Katja N, Slangen, Brigitte FM, Vergote, Ignace, Brännström, Mats, van Dorst, Eleonora BL, van Driel, Willemien J, Hermans, Ralph H, Nunns, David, Widschwendter, Martin, Nugent, David, Holland, Cathrine M, Sharma, Aarti, DiSilvestro, Paul A, Mannel, Robert, Boll, Dorry, Cibula, David, Covens, Al, Provencher, Diane, Runnebaum, Ingo B, Luesley, David, Ellis, Patricia, Duncan, Timothy J, Tjiong, Ming Y, Cruickshank, Derek J, Kjølhede, Preben, Levenback, Charles F, Bouda, Jiri, Kieser, Katharina E, Palle, Connie, Spirtos, Nicola M, O'Malley, David M, Leitao, Mario M, Geller, Melissa A, Dhar, Kalyan, Asher, Viren, Tamussino, Karl, Tobias, Daniel H, Borgfeldt, Christer, Lea, Jayanthi S, Bailey, Jo, Lood, Margareta, Eyjolfsdottir, Brynhildur, Attard-Montalto, Stephen, Tewari, Krishnansu S, Manchanda, Ranjit, Jensen, Pernille T, Persson, Par, Van Le, Linda, Putter, Hein, de Bock, Geertruida H, Monk, Bradley J, Creutzberg, Carien L, and van der Zee, Ate GJ

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Clinical Trials and Supportive Activities, Clinical Research, Cancer, Evaluation of treatments and therapeutic interventions, 6.5 Radiotherapy and other non-invasive therapies, Aged, Female, Humans, Lymph Node Excision, Lymphatic Metastasis, Middle Aged, Neoplasm Micrometastasis, Neoplasm Staging, Prospective Studies, Radiation Dosage, Sentinel Lymph Node, Time Factors, Treatment Outcome, Vulvar Neoplasms, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

PurposeThe Groningen International Study on Sentinel nodes in Vulvar cancer (GROINSS-V)-II investigated whether inguinofemoral radiotherapy is a safe alternative to inguinofemoral lymphadenectomy (IFL) in vulvar cancer patients with a metastatic sentinel node (SN).MethodsGROINSS-V-II was a prospective multicenter phase-II single-arm treatment trial, including patients with early-stage vulvar cancer (diameter < 4 cm) without signs of lymph node involvement at imaging, who had primary surgical treatment (local excision with SN biopsy). Where the SN was involved (metastasis of any size), inguinofemoral radiotherapy was given (50 Gy). The primary end point was isolated groin recurrence rate at 24 months. Stopping rules were defined for the occurrence of groin recurrences.ResultsFrom December 2005 until October 2016, 1,535 eligible patients were registered. The SN showed metastasis in 322 (21.0%) patients. In June 2010, with 91 SN-positive patients included, the stopping rule was activated because the isolated groin recurrence rate in this group went above our predefined threshold. Among 10 patients with an isolated groin recurrence, nine had SN metastases > 2 mm and/or extracapsular spread. The protocol was amended so that those with SN macrometastases (> 2 mm) underwent standard of care (IFL), whereas patients with SN micrometastases (≤ 2 mm) continued to receive inguinofemoral radiotherapy. Among 160 patients with SN micrometastases, 126 received inguinofemoral radiotherapy, with an ipsilateral isolated groin recurrence rate at 2 years of 1.6%. Among 162 patients with SN macrometastases, the isolated groin recurrence rate at 2 years was 22% in those who underwent radiotherapy, and 6.9% in those who underwent IFL (P = .011). Treatment-related morbidity after radiotherapy was less frequent compared with IFL.ConclusionInguinofemoral radiotherapy is a safe alternative for IFL in patients with SN micrometastases, with minimal morbidity. For patients with SN macrometastasis, radiotherapy with a total dose of 50 Gy resulted in more isolated groin recurrences compared with IFL.

Published
2021

13. Cancer worry among BRCA1/2 pathogenic variant carriers choosing surgery to prevent tubal/ovarian cancer: course over time and associated factors

Author

van Bommel, Majke H. D., Steenbeek, Miranda P., IntHout, Joanna, Hermens, Rosella P. M. G., Hoogerbrugge, Nicoline, Harmsen, Marline G., van Doorn, Helena C., Mourits, Marian J. E., van Beurden, Marc, Zweemer, Ronald P., Gaarenstroom, Katja N., Slangen, Brigitte F. M., Brood-van Zanten, Monique M. A., Vos, M. Caroline, Piek, Jurgen M., van Lonkhuijzen, Luc R. C. W., Apperloo, Mirjam J. A., Coppus, Sjors F. P. J., Prins, Judith B., Custers, José A. E., and de Hullu, Joanne A.

Published
2022
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15. Diagnosis and management of isolated serous tubal intraepithelial carcinoma: A qualitative focus group study.

Author

Negri, Serena, Fisch, Charlotte, de Hullu, Joanne A., van Bommel, Majke, Simons, Michiel, Bogaerts, Joep, Apperloo, Mirjam J.A., Baiocchi, Glauco, Bakker, Janine L., Bart, Joost, van Beekhuizen, Heleen J., Bernardini, Marcus Q., Boere, Ingrid, Bulten, Johan, Chen, Lee‐may, Chrzan, Alicja, Dørum, Anne, Ewing‐Graham, Patricia C., Ferrero, Annamaria, and Flöter Rådestad, Angelique

Subjects
FALLOPIAN tubes, RESEARCH personnel, PERITONEAL cancer, FOCUS groups, GYNECOLOGISTS
Abstract

Objective: A Serous Tubal Intraepithelial Carcinoma (STIC) without concomitant invasive carcinoma is occasionally identified and associated with a high risk of subsequent peritoneal carcinomatosis. Management needs optimisation. This study explores professionals' opinions and clinical practices regarding the diagnosis, counselling, treatment and follow‐up of isolated STIC to facilitate clinical decision making and optimise the direction of future research. A secondary aim is to assess international clinical guidelines. Design: Focus group study. Setting: Four online sessions. Population: International panel (n = 12 countries) of gynaecologists, gynaecologic oncologists, pathologists and medical oncologists (n = 49). Methods: A semi‐structured interview guide was used. Two independent researchers analysed transcripts by open and axial coding. Results were organised in domains. Relevant (inter)national guidelines were screened for recommendations regarding isolated STIC. Main Outcome Measures: Professionals' opinions and clinical practices regarding isolated STIC management. Results: Regarding pathology, most professionals identified the SEE‐FIM protocol as standard of care for high‐risk patients, whereas variation exists in the histopathological examination of fallopian tubes in the general population. Confirmation of STIC diagnosis by a specialised pathologist was recommended. Regarding work‐up and follow‐up after STIC diagnosis, there was variety and discordance. Data on outcomes is limited. As for treatment, chemotherapy and PARP inhibitors were not recommended by most. Eleven guidelines provided limited recommendations. Conclusions: We identified recommendations and highlighted knowledge gaps in the diagnosis and management of isolated STIC. Moreover, recommendations in clinical guidelines are limited. There is an agreed need for international collaboration for the prospective registration of isolated STIC. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Long-term bone health in women with a premenopausal risk-reducing salpingo-oophorectomy (RRSO) compared with women who underwent

Author

Beekman, Maarten, primary, Terra, Lara, additional, Stuursma, Anniek, additional, Heemskerk-Gerritsen, Bernadette, additional, van, Beurden Marc, additional, van, Doorn Lena, additional, van, Dorst Eleonora, additional, de, Hullu Joanne, additional, Mom, Stijn, additional, Roeters, van Lennep Jeanine, additional, Gaarenstroom, Katja, additional, Korse, Tiny, additional, de, Keizer Bart, additional, Mitea, Cristina, additional, Slart, Riemer, additional, Miranda, Snoeren, additional, Stokkel, Marcel, additional, Verberne, Hein, additional, van, Asperen Christi, additional, Ausems, Margreet, additional, Berger, Lieke, additional, de, Bock Truuske, additional, Margriet, Collee, additional, van, Engelen Klaartje, additional, van, der Kolk Lizet, additional, Wevers, Marijke, additional, Gomez, Garcia Encarna, additional, Hooning, Maartje, additional, Maas, Angela, additional, Mourits, Marian, additional, van, Leeuwen Flora, additional, and Zillikens, Carola, additional

Published
2024
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21. Evaluation of a patient decision aid for BRCA1/2 pathogenic variant carriers choosing an ovarian cancer prevention strategy

Author

Steenbeek, Miranda P., van Bommel, Majke H.D., Harmsen, Marline G., Hoogerbrugge, Nicoline, van Doorn, Helena C., Keurentjes, José H.M., van Beurden, Marc, Zweemer, Ronald P., Gaarenstroom, Katja N., Penders, Charlotte G.J., Brood-van Zanten, Monique M.A., Vos, M. Caroline, Piek, Jurgen M., van Lonkhuijzen, Luc R.C.W., Apperloo, Mirjam J.A., Coppus, Sjors F.P.J., IntHout, Joanna, de Hullu, Joanne A., and Hermens, Rosella P.M.G.

Published
2021
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26. Long-term outcome of high-grade serous carcinoma established in risk-reducing salpingo-oophorectomy specimens in asymptomatic BRCA1/2 germline pathogenic variant carriers

Author

MS Gynaecologische Oncologie, Cancer, Genetica, Genetica Klinische Genetica, Stroot, Iris A.S., Bart, Joost, Hollema, Harry, Jalving, Mathilde, Wagner, Marise M., Yigit, Refika, van Doorn, Helena C., de Hullu, Joanne A., Gaarenstroom, Katja N., van Beurden, Marc, van Lonkhuijzen, Luc R.C.W., Slangen, Brigitte F.M., Zweemer, Ronald P., Gómez García, Encarna B., Ausems, Margreet G.E.M., Boere, Ingrid A., van Hest, Liselotte P., Duijkers, Floor A.M., van Asperen, Christi J., Schmidt, Marjanka K., Wevers, Marijke R., Ruijs, Marielle W.G., Devilee, Peter, Collée, J. Margriet, HEBON investigators, investigators, de Bock, Geertruida H., Mourits, Marian J.E., MS Gynaecologische Oncologie, Cancer, Genetica, Genetica Klinische Genetica, Stroot, Iris A.S., Bart, Joost, Hollema, Harry, Jalving, Mathilde, Wagner, Marise M., Yigit, Refika, van Doorn, Helena C., de Hullu, Joanne A., Gaarenstroom, Katja N., van Beurden, Marc, van Lonkhuijzen, Luc R.C.W., Slangen, Brigitte F.M., Zweemer, Ronald P., Gómez García, Encarna B., Ausems, Margreet G.E.M., Boere, Ingrid A., van Hest, Liselotte P., Duijkers, Floor A.M., van Asperen, Christi J., Schmidt, Marjanka K., Wevers, Marijke R., Ruijs, Marielle W.G., Devilee, Peter, Collée, J. Margriet, HEBON investigators, investigators, de Bock, Geertruida H., and Mourits, Marian J.E.

Published
2024

27. Cervicovaginal specimen biomarkers for early detection of ovarian and endometrial cancer: A review.

Author

Kwinten, Kevin J. J., Lemain, Victor A., de Hullu, Joanne A., Leenders, William P. J., Steenbeek, Miranda P., van Altena, Anne M., and Pijnenborg, Johanna M. A.

Subjects
OVARIAN cancer, EARLY detection of cancer, TECHNOLOGICAL innovations, DNA methylation, ENDOMETRIAL cancer, HEREDITARY cancer syndromes
Abstract

Background: In the last decade, technical innovations have resulted in the development of several minimally invasive diagnostic cancer tools. Within women at high risk of developing ovarian or endometrial cancer (EC) due to hereditary cancer syndrome, there is an urgent need for minimally invasive and patient‐friendly methods to detect ovarian cancer and EC at an early stage. Materials and Methods: We performed a systematic search of studies using DNA methylation or mutation analysis, microbiome, or proteomics performed on cervicovaginal specimens (smear, swab, or tampon) intended to detect ovarian and EC published until January 2024. Results: Included studies (n = 36) showed high heterogeneity in terms of biomarkers used and outcomes, and only a few studies reported on the detection of biomarkers in high‐risk subgroups. Conclusion: Based on the findings in this review, DNA methylation techniques seem to be the most promising for detecting ovarian and EC at early stages in the general population. Future validation of cervicovaginal DNA methylation techniques is needed to determine whether this technique might be beneficial in hereditary high‐risk subgroups. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Vulvar cancer and vulvar premalignancies

Author

de Hullu, Joanne A., van der Avoort, Irene A. M., Oonk, Maaike H. M., van Poelgeest, Mariette I. E., Steegers, Eric A.P., editor, Fauser, Bart C.J.M., editor, Hilders, Carina G.J.M., editor, Jaddoe, Vincent W.V., editor, Massuger, Leon F.A.G., editor, van der Post, Joris A.M., editor, and Schoenmakers, Sam, editor

Published
2019
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31. Fallopian tube abnormalities in uterine serous carcinoma

Author

Steenbeek, Miranda P., Bulten, Johan, Snijders, Marc P.L.M., Lombaers, Marike, Hendriks, Jeanine, van den Brand, Michiel, Kraayenbrink, Arjan A., Massuger, Leon F.A.G., Sweegers, Sanne, de Hullu, Joanne A., Pijnenborg, Johanna M.A., Küsters-Vandevelde, Heidi V.N., and Reijnen, Casper

Published
2020
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32. Sexual functioning more than 15 years after premenopausal risk-reducing salpingo-oophorectomy

Author

Terra, Lara, Beekman, Maarten J., Engelhardt, Ellen G., Heemskerk-Gerritsen, Bernadette A.M., van Beurden, Marc, Roeters van Lennep, Jeanine E., van Doorn, Helena C., de Hullu, Joanne A., Van Dorst, Eleonora B.L., Mom, Constantijne H., Slangen, Brigitte F.M., Gaarenstroom, Katja N., van der Kolk, Lizet E., Collée, J. Margriet, Wevers, Marijke R., Ausems, Margreet G.E.M., Van Engelen, Klaartje, van de Beek, Irma, Berger, Lieke P.V., van Asperen, Christi J., Gomez Garcia, Encarna B., Maas, Angela H.E.M., Hooning, Maartje J., Aaronson, Neil K., Mourits, Marian J.E., and van Leeuwen, Flora E.

Published
2023
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39. Long-Term Morbidity and Health After Early Menopause Due to Oophorectomy in Women at Increased Risk of Ovarian Cancer: Protocol for a Nationwide Cross-Sectional Study With Prospective Follow-Up (HARMOny Study)

Author

Terra, Lara, Hooning, Maartje J, Heemskerk-Gerritsen, Bernadette A M, van Beurden, Marc, Roeters van Lennep, Jeanine E, van Doorn, Helena C, de Hullu, Joanne A, Mom, Constantijne, van Dorst, Eleonora B L, Mourits, Marian J E, Slangen, Brigitte F M, Gaarenstroom, Katja N, Zillikens, M Carola, Leiner, Tim, van der Kolk, Lizet, Collee, Margriet, Wevers, Marijke, Ausems, Margreet G E M, van Engelen, Klaartje, Berger, Lieke PV, van Asperen, Christi J, Gomez-Garcia, Encarna B, van de Beek, Irma, Rookus, Matti A, Hauptmann, Michael, Bleiker, Eveline M, Schagen, Sanne B, Aaronson, Neil K, Maas, Angela H E M, and van Leeuwen, Flora E

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundBRCA1/2 mutation carriers are recommended to undergo risk-reducing salpingo-oophorectomy (RRSO) at 35 to 45 years of age. RRSO substantially decreases ovarian cancer risk, but at the cost of immediate menopause. Knowledge about the potential adverse effects of premenopausal RRSO, such as increased risk of cardiovascular disease, osteoporosis, cognitive dysfunction, and reduced health-related quality of life (HRQoL), is limited. ObjectiveThe aim of this study is to assess the long-term health effects of premenopausal RRSO on cardiovascular disease, bone health, cognitive functioning, urological complaints, sexual functioning, and HRQoL in women with high familial risk of breast or ovarian cancer. MethodsWe will conduct a multicenter cross-sectional study with prospective follow-up, nested in a nationwide cohort of women at high familial risk of breast or ovarian cancer. A total of 500 women who have undergone RRSO before 45 years of age, with a follow-up period of at least 10 years, will be compared with 250 women (frequency matched on current age) who have not undergone RRSO or who have undergone RRSO at over 55 years of age. Participants will complete an online questionnaire on lifestyle, medical history, cardiovascular risk factors, osteoporosis, cognitive function, urological complaints, and HRQoL. A full cardiovascular assessment and assessment of bone mineral density will be performed. Blood samples will be obtained for marker analysis. Cognitive functioning will be assessed objectively with an online neuropsychological test battery. ResultsThis study was approved by the institutional review board in July 2018. In February 2019, we included our first participant. As of November 2020, we had enrolled 364 participants in our study. ConclusionsKnowledge from this study will contribute to counseling women with a high familial risk of breast/ovarian cancer about the long-term health effects of premenopausal RRSO. The results can also be used to offer health recommendations after RRSO. Trial RegistrationClinicalTrials.gov NCT03835793; https://clinicaltrials.gov/ct2/show/NCT03835793. International Registered Report Identifier (IRRID)DERR1-10.2196/24414

Published
2021
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43. Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study

Author

Pleunis, Noortje, primary, Pouwer, Anne-Floor W., additional, Oonk, Maaike H. M., additional, van Doorn, Helena C., additional, Tjiong, Ming Y., additional, van der Velden, Jacobus, additional, Zijlmans, Henry, additional, van Poelgeest, Mariette I. E., additional, van Dorst, Eleonora B., additional, Slangen, Brigitte F. M., additional, Verhoef, Lia C. G., additional, Pijnenborg, Johanna M. A., additional, and de Hullu, Joanne A., additional

Published
2023
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45. Care after premenopausal risk‐reducing salpingo‐oophorectomy in high‐risk women: Scoping review and international consensus recommendations

Author

Nebgen, Denise R., primary, Domchek, Susan M., additional, Kotsopoulos, Joanne, additional, de Hullu, Joanne A., additional, Crosbie, Emma J., additional, Paramanandam, Vincent Singh, additional, Brood ‐ van Zanten, Monique M.A., additional, Norquist, Barbara M., additional, Guise, Theresa, additional, Rozenberg, Serge, additional, Kurian, Allison W., additional, Pederson, Holly J., additional, Yuksel, Nese, additional, Michaelson‐Cohen, Rachel, additional, Bober, Sharon L., additional, da Silva Filho, Agnaldo Lopes, additional, Johansen, Nora, additional, Guidozzi, F., additional, Evans, D. Gareth, additional, Menon, Usha, additional, Kingsberg, Sheryl A., additional, Powell, C. Bethan, additional, Grandi, Giovanni, additional, Marchetti, Claudia, additional, Jacobson, Michelle, additional, Brennan, Donal J., additional, and Hickey, Martha, additional

Published
2023
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46. Consensus based recommendations for the diagnosis of serous tubal intraepithelial carcinoma: an international Delphi study

Author

Bogaerts, Joep M. A., van Bommel, Majke H. D., Hermens, Rosella P. M. G., Steenbeek, Miranda P., de Hullu, Joanne A., van der Laak, Jeroen, STIC Consortium, Simons, Michiel, Bogaerts, Joep M. A., van Bommel, Majke H. D., Hermens, Rosella P. M. G., Steenbeek, Miranda P., de Hullu, Joanne A., van der Laak, Jeroen, STIC Consortium, and Simons, Michiel

Abstract

AimReliably diagnosing or safely excluding serous tubal intraepithelial carcinoma (STIC), a precursor lesion of tubo-ovarian high-grade serous carcinoma (HGSC), is crucial for individual patient care, for better understanding the oncogenesis of HGSC, and for safely investigating novel strategies to prevent tubo-ovarian carcinoma. To optimize STIC diagnosis and increase its reproducibility, we set up a three-round Delphi study. Methods and resultsIn round 1, an international expert panel of 34 gynecologic pathologists, from 11 countries, was assembled to provide input regarding STIC diagnosis, which was used to develop a set of statements. In round 2, the panel rated their level of agreement with those statements on a 9-point Likert scale. In round 3, statements without previous consensus were rated again by the panel while anonymously disclosing the responses of the other panel members. Finally, each expert was asked to approve or disapprove the complete set of consensus statements. The panel indicated their level of agreement with 64 statements. A total of 27 statements (42%) reached consensus after three rounds. These statements reflect the entire diagnostic work-up for pathologists, regarding processing and macroscopy (three statements); microscopy (eight statements); immunohistochemistry (nine statements); interpretation and reporting (four statements); and miscellaneous (three statements). The final set of consensus statements was approved by 85%. ConclusionThis study provides an overview of current clinical practice regarding STIC diagnosis amongst expert gynecopathologists. The experts consensus statements form the basis for a set of recommendations, which may help towards more consistent STIC diagnosis., Funding Agencies|Dutch Cancer Society (KWF kankerbestrijding)

Published
2023
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47. TUBectomy with delayed oophorectomy as an alternative to risk-reducing salpingo-oophorectomy in high-risk women to assess the safety of prevention: the TUBA-WISP II study protocol

Author

Steenbeek, M, van Bommel, M, Inthout, J, Peterson, C, Simons, M, Roes, K, Kets, M, Norquist, B, Swisher, E, Hermens, R, Lu, K, de Hullu, J, Fruscio, R, Steenbeek, Miranda P, van Bommel, Majke H D, intHout, Joanna, Peterson, Christine B, Simons, Michiel, Roes, Kit C B, Kets, Marleen, Norquist, Barbara M, Swisher, Elizabeth M, Hermens, Rosella P M G, Lu, Karen H, de Hullu, Joanne A, Fruscio, Robert, Steenbeek, M, van Bommel, M, Inthout, J, Peterson, C, Simons, M, Roes, K, Kets, M, Norquist, B, Swisher, E, Hermens, R, Lu, K, de Hullu, J, Fruscio, R, Steenbeek, Miranda P, van Bommel, Majke H D, intHout, Joanna, Peterson, Christine B, Simons, Michiel, Roes, Kit C B, Kets, Marleen, Norquist, Barbara M, Swisher, Elizabeth M, Hermens, Rosella P M G, Lu, Karen H, de Hullu, Joanne A, and Fruscio, Robert

Abstract

Background: Risk-reducing salpingectomy with delayed oophorectomy has gained interest for individuals at high risk for tubo-ovarian cancer as there is compelling evidence that especially high-grade serous carcinoma originates in the fallopian tubes. Two studies have demonstrated a positive effect of salpingectomy on menopause-related quality of life and sexual health compared with standard risk-reducing salpingo-oophorectomy. Primary Objective: To investigate whether salpingectomy with delayed oophorectomy is non-inferior to the current standard salpingo-oophorectomy for the prevention of tubo-ovarian cancer among individuals at high inherited risk. Study Hypothesis: We hypothesize that postponement of oophorectomy after salpingectomy, to the age of 40-45 (BRCA1) or 45-50 (BRCA2) years, compared with the current standard salpingo-oophorectomy at age 35-40 (BRCA1) or 40-45 (BRCA2) years, is non-inferior in regard to tubo-ovarian cancer risk. Trial Design: In this international prospective preference trial, participants will choose between the novel salpingectomy with delayed oophorectomy and the current standard salpingo-oophorectomy. Salpingectomy can be performed after the completion of childbearing and between the age of 25 and 40 (BRCA1), 25 and 45 (BRCA2), or 25 and 50 (BRIP1, RAD51C, and RAD51D pathogenic variant carriers) years. Subsequent oophorectomy is recommended at a maximum delay of 5 years beyond the upper limit of the current guideline age for salpingo-oophorectomy. The current National Comprehensive Cancer Network (NCCN) guideline age, which is also the recommended age for salpingo-oophorectomy within the study, is 35-40 years for BRCA1, 40-45 years for BRCA2, and 45-50 years for BRIP1, RAD51C, and RAD51D pathogenic variant carriers. Major Inclusion/Exclusion Criteria: Premenopausal individuals with a documented class IV or V germline pathogenic variant in the BRCA1, BRCA2, BRIP1, RAD51C, or RAD51D gene who have completed childbearing are eligible for

Published
2023

48. High-Grade Serous Carcinoma at Risk-Reducing Salpingo-Oophorectomy in Asymptomatic Carriers of BRCA1/2 Pathogenic Variants:Prevalence and Clinical Factors

Author

Stroot, Iris A S, Brouwer, Jan, Bart, Joost, Hollema, Harry, Stommel-Jenner, Denise J, Wagner, Marise M, van Doorn, Helena C, de Hullu, Joanne A, Gaarenstroom, Katja N, Beurden, Marc, van Lonkhuijzen, Luc R C W, Slangen, Brigitte F M, Zweemer, Ronald P, Gómez Garcia, Encarna B, Ausems, Margreet G E M, Boere, Ingrid A, van Engelen, Klaartje, van Asperen, Christi J, Schmidt, Marjanka K, Wevers, Marijke R, de Bock, Geertruida H, Mourits, Marian J E, Stroot, Iris A S, Brouwer, Jan, Bart, Joost, Hollema, Harry, Stommel-Jenner, Denise J, Wagner, Marise M, van Doorn, Helena C, de Hullu, Joanne A, Gaarenstroom, Katja N, Beurden, Marc, van Lonkhuijzen, Luc R C W, Slangen, Brigitte F M, Zweemer, Ronald P, Gómez Garcia, Encarna B, Ausems, Margreet G E M, Boere, Ingrid A, van Engelen, Klaartje, van Asperen, Christi J, Schmidt, Marjanka K, Wevers, Marijke R, de Bock, Geertruida H, and Mourits, Marian J E

Abstract

PURPOSE: To investigate the prevalence of and clinical factors associated with high-grade serous carcinoma (HGSC) at risk-reducing salpingo-oophorectomy (RRSO) in asymptomatic BRCA1/2-pathogenic variant (PV) carriers.PATIENTS AND METHODS: We included BRCA1/2-PV carriers who underwent RRSO between 1995 and 2018 from the Hereditary Breast and Ovarian cancer in the Netherlands study. All pathology reports were screened, and histopathology reviews were performed for RRSO specimens with epithelial abnormalities or where HGSC developed after normal RRSO. We then compared clinical characteristics, including parity and oral contraceptive pill (OCP) use, for women with and without HGSC at RRSO.RESULTS: Of the 2,557 included women, 1,624 had BRCA1, 930 had BRCA2, and three had both BRCA1/2-PV. The median age at RRSO was 43.0 years (range: 25.3-73.8) for BRCA1-PV and 46.8 years (27.6-77.9) for BRCA2-PV carriers. Histopathologic review confirmed 28 of 29 HGSCs and two further HGSCs from among 20 apparently normal RRSO specimens. Thus, 24 (1.5%) BRCA1-PV and 6 (0.6%) BRCA2-PV carriers had HGSC at RRSO, with the fallopian tube identified as the primary site in 73%. The prevalence of HGSC in women who underwent RRSO at the recommended age was 0.4%. Among BRCA1/2-PV carriers, older age at RRSO increased the risk of HGSC and long-term OCP use was protective.CONCLUSION: We detected HGSC in 1.5% (BRCA1-PV) and 0.6% (BRCA2-PV) of RRSO specimens from asymptomatic BRCA1/2-PV carriers. Consistent with the fallopian tube hypothesis, we found most lesions in the fallopian tube. Our results highlight the importance of timely RRSO with total removal and assessment of the fallopian tubes and show the protective effects of long-term OCP.

Published
2023

49. Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study

Author

MS Gynaecologische Oncologie, Cancer, Pleunis, Noortje, Pouwer, Anne-Floor W, Oonk, Maaike H M, van Doorn, Helena C, Tjiong, Ming Y, van der Velden, Jacobus, Zijlmans, Henry, van Poelgeest, Mariette I E, van Dorst, Eleonora B, Slangen, Brigitte F M, Verhoef, Lia C G, Pijnenborg, Johanna M A, de Hullu, Joanne A, MS Gynaecologische Oncologie, Cancer, Pleunis, Noortje, Pouwer, Anne-Floor W, Oonk, Maaike H M, van Doorn, Helena C, Tjiong, Ming Y, van der Velden, Jacobus, Zijlmans, Henry, van Poelgeest, Mariette I E, van Dorst, Eleonora B, Slangen, Brigitte F M, Verhoef, Lia C G, Pijnenborg, Johanna M A, and de Hullu, Joanne A

Published
2023

50. The most efficient and effective BRCA1/2 testing strategy in epithelial ovarian cancer: Tumor-First or Germline-First?

Author

Genetica Klinische Genetica, Cancer, Witjes, Vera M, Ligtenberg, Marjolijn J L, Vos, Janet R, Braspenning, Jozé C C, Ausems, Margreet G E M, Mourits, Marian J E, de Hullu, Joanne A, Adang, Eddy M M, Hoogerbrugge, Nicoline, Genetica Klinische Genetica, Cancer, Witjes, Vera M, Ligtenberg, Marjolijn J L, Vos, Janet R, Braspenning, Jozé C C, Ausems, Margreet G E M, Mourits, Marian J E, de Hullu, Joanne A, Adang, Eddy M M, and Hoogerbrugge, Nicoline

Published
2023

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