Ovarian cancer surgery and brca test: A nationwide Italian survey

Abstract

Background. Ovarian cancer (OC) is the most lethal gynecological malignancy in developed countries. Beyond surgery, the backbone treatment of advanced OC is platinumbased chemotherapy. The traditional treatments can be improved by the addition of new target therapies and the breast-related cancer antigens (BRCA) genes represents a potential therapeutic target. Current guidelines recommend BRCA testing for all epithelial OC patients. The objective of the present study is to elucidate the actual scenario of the Italian OC care centers regarding surgery and BRCA testing. Methods. We conducted a web-based cross-sectional national survey. All invited participants received an e-mail with a 21-item electronic questionnaire accessible through a direct anonymized link. No formal statistical hypothesis was predefined according to the exploratory intent of the survey. Results. Two hundred-sixtythree potential centers were involved in the survey; 109/263 centers (41.4%) declared advanced OC treatment expertise and are more frequently located in Northern and Central Italian regions (p=0.0003). In the southern Italy, OC centers usually refer patients to other centers (p=005). Most centers (>50%) perform BRCA test in more than 60% of their OC patients but only 36.1% of centers request BRCA status on tumor tissue (sBRCA). Conclusions. BRCA testing is not homogeneously diffused throughout Italian regions and overall sBRCA testing is not high (36.1%). In the era of personalized medicine, sBRCA testing should be offered to all epithelial OC patients to guarantee target therapy and prevention strategies for relatives with BRCA mutation.