Risk-Reducing Surgeries in Gynecological Cancers: A Review of the Current State

Öz

Risk-reducing surgery has an important role to play in the prevention of gynaecological cancers, particularly in women who are at high risk of these cancers. Risk-reducing bilateral salpingo-oophorectomy (rrBSO) has been shown to significantly reduce the risk of ovarian and fallopian tube cancers and all-cause mortality in women with BRCA1/2 mutations. Combined prophylactic hysterectomy and bilateral salpingo-oophorectomy is recommended for patients with Lynch syndrome and has been shown to reduce the risk of endometrial and ovarian cancer. Although long-term data are needed, opportunistic salpingectomy is considered to be an effective method of reducing the risk of epithelial ovarian cancer. Based on genetic mutations and individual risk factors, risk-reducing surgery for gynaecological cancers is an important component of personalised treatment plans. The aim of this review is to provide a comprehensive analysis of the different surgical strategies associated with BRCA1/2 mutations, Lynch syndrome and other hereditary conditions. It evaluates the role and potential benefits of surgical interventions such as risk-reducing bilateral salpingo-oophorectomy (rrBSO), prophylactic hysterectomy and opportunistic salpingectomy in clinical practice, and assesses their efficacy and feasibility.

Anahtar Kelimeler

• risk-reducing surgery
• endometrial cancer
• bilateral salpingo-oophorectomy
• hereditary cancer syndromes
• ovarian cancer

Jinekolojik Kanserlerde Risk Azaltıcı Cerrahiler: Güncel Duruma Bakış

Öz

Risk azaltıcı cerrahi, özellikle yüksek risk altındaki kadınlarda jinekolojik kanserlerin önlenmesinde önemli bir rol oynamaktadır. Risk azaltıcı bilateral salpingo-ooferektomi (rrBSO), BRCA1/2 mutasyonları taşıyan kadınlarda over ve fallop tüpü kanserlerine bağlı mortalite riskini anlamlı şekilde azaltmaktadır. Lynch sendromu olan hastalarda kombine profilaktik histerektomi ve bilateral salpingo-ooferektomi önerilmektedir ve bu yaklaşımın endometriyal ve over kanseri riskini azalttığı gösterilmiştir. Uzun dönem verilerine ihtiyaç duyulmasına rağmen, fırsatçı salpenjektomi, epitelyal over kanseri riskini azaltmada etkili bir yöntem olarak değerlendirilmektedir. Genetik mutasyonlar ve bireysel risk faktörlerine dayanarak, jinekolojik kanserler için risk azaltıcı cerrahi, kişiselleştirilmiş tedavi planlarının önemli bir bileşeni olarak kabul edilmektedir. Bu derleme, BRCA1/2 mutasyonları, Lynch sendromu ve diğer kalıtsal durumlarla ilişkili çeşitli cerrahi stratejileri kapsamlı bir şekilde analiz etmeyi amaçlamaktadır. rrBSO, profilaktik histerektomi ve oportunistik salpenjektomi gibi cerrahi müdahalelerin etkinliğini ve uygulanabilirliğini değerlendirerek, bu prosedürlerin klinik pratikteki rolünü ve potansiyel yararlarını incelemeyi amaçlamaktadır.

Anahtar Kelimeler

• risk azaltıcı cerrahiler
• endometriyum kanseri
• çift taraflı salpingo-ooferektomi
• kalıtsal kanser sendromları
• yumurtalık kanseri

Teşekkür

Saygıdeğer Prof. Dr. M. Recep PEKCİCİ tarafından davet ile yazdığımız derleme için kendisine teşekkürlerimizi sunarız.

Kaynakça

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