Management of incidental STIC lesions with and without BRCA mutations: a survey of current clinical practice in Austria, Germany, and Switzerland

对伴有或不伴有 BRCA 突变的偶然发现的 STIC 病变的管理:奥地利、德国和瑞士当前临床实践调查

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Abstract

OBJECTIVE: The aim of this study was to assess current clinical practices, management, and follow-up care for women with an isolated serous tubal intraepithelial carcinoma (STIC) diagnosis in German-speaking countries. METHODS: An online survey targeting all German-speaking gynecological centers was developed. The survey included single- and multiple-choice questions on hospital data, such as the number of cases per year and certification, as well as detailed questions on two scenarios: a BRCA1-positive patient undergoing prophylactic bilateral salpingo-oophorectomy and a patient with an incidental STIC finding after hysterectomy and bilateral salpingectomy. RESULTS: This survey was answered by 77 physicians. For a patient with a known BRCA1 mutation and STIC, 89.29% of respondents would perform further diagnostics. The most frequent diagnostic steps would be a CA-125 test (83.64%) and a CT abdomen (63.64%). Further surgery would be performed by 77.78% of respondents, including 75.93% without and 5.56% with lymph node staging. 79.25% would prefer laparoscopic surgery. The majority (90.57%) would not recommend adjuvant therapy. In a patient without a known mutation and STIC, 88.46% of respondents would recommend further examinations. 58.82% would carry out genetic panel testing. Another subsequent surgery would be performed by 76.47%, with 66.67% planning to perform surgery without lymph node staging. 53.06% of respondents would follow up patients for five years. Percentages are reported based on the number of valid responses for each item. CONCLUSION: This survey demonstrates differences in the clinical management of isolated STIC across German-speaking countries, highlighting discrepancies between guideline recommendations and real-world practices. THIS STUDY IS REGISTERED IN THE GERMAN CLINICAL TRIALS REGISTER UNDER : DRKS00033112.

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