Long-Term Ovarian Cancer Survival Associated With Mutation in BRCA1 or BRCA2

Long-Term Ovarian Cancer Survival Associated With Mutation in BRCA1 or BRCA2

1. John R. McLaughlin,


2. Barry Rosen,


3. Joel Moody,


4. Tuya Pal,


5. Isabel Fan,


6. Patricia A. Shaw,


7. Harvey A. Risch,


8. Thomas A. Sellers,


9. Ping Sun and


10. Steven A. Narod

+ Author Affiliations

1. 
   Affiliations of authors: Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Canada (JRM, JM, IF); Department of Gynecology, Princess Margaret Hospital (BR) and Women’s College Research Institute (PS, SAN), University of Toronto, Toronto, Canada (BR); Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL (TP, TAS); Department of Pathology, University Health Network, Toronto, Canada (PAS); Department of Epidemiology and Public Health, Yale University School of Public Health, School of Medicine, New Haven, CT (HAR).
   
   

1. Correspondence to: Steven A Narod, MD, Women’s College Research Institute, 790 Bay St, 7th Fl, Toronto, ON, M5G 1N8 Canada (e-mail: Steven.Narod@wchospital.ca).

• Received August 13, 2012.


• Revision received October 19, 2012.


• Accepted October 22, 2012.

Abstract

Background Studies have suggested that the 5-year survival of women with ovarian cancer and a BRCA1 or BRCA2 mutation is better than expected. We sought to evaluate the impact of carrying a BRCA1 or BRCA2 mutation on long-term survival of women after a diagnosis of invasive ovarian cancer.

Methods One thousand six hundred twenty-six unselected women diagnosed with invasive ovarian cancer in Ontario, Canada, or in Tampa, Florida, between 1995 and 2004 were followed for a mean of 6.9 years (range = 0.3 to 15.7 years). Mutation screening for BRCA1 and BRCA2 revealed mutations in 218 women (13.4%). Left-truncated survival analysis was conducted to estimate ovarian cancer–specific survival at various time points after diagnosis for women with and without mutations.

Results In the 3-year period after diagnosis, the presence of a BRCA1 or BRCA2 mutation was associated with a better prognosis (adjusted hazard ratio = 0.68, 95% confidence interval [CI] = 0.48 to 0.98; P = .03), but at 10 years after diagnosis, the hazard ratio was 1.00 (95% CI = 0.83 to 1.22; P = .90). Among women with serous ovarian cancers, 27.4% of women who were BRCA1 mutation carriers, 27.7% of women who were BRCA2 carriers, and 27.1% of women who were noncarriers were alive at 12 years past diagnosis.

Conclusion For women with invasive ovarian cancer, the short-term survival advantage of carrying a BRCA1 or BRCA2 mutation does not lead to a long-term survival benefit.

• © The Author 2012. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.