Women with the Lynch syndrome have a 40% to 60% lifetime risk of endometrial cancer, and 10% to 12% lifetime risk of ovarian cancer.
The benefit of prophylactic gynecologic surgery for women with this syndrome has been uncertain.
Dr Lu and colleagues determined the reduction in the risk of gynecologic cancers associated with prophylactic hysterectomy.
The team also evaluated the reduction of gynecologic cancer risk associated with bilateral salpingo-oophorectomy in women with the Lynch syndrome.
The research team identified 315 women with documented germ-line mutations associated with the Lynch syndrome.
| Endometrial cancer was diagnosed in 33% of women|
|New England Journal of Medicine|
The team included 61 women who had undergone prophylactic hysterectomy, and 47 women who had undergone prophylactic bilateral salpingo-oophorectomy.
These women were matched with 210 who had not undergone the procedure in question for the analysis of endometrial cancer, and 223 for the analysis of ovarian cancer.
Women who had undergone prophylactic surgery and their matched controls were followed from the date of the surgery until the occurrence of cancer.
The participants were also followed until the data were censored at the time of the last follow-up visit.
The researchers found no occurrences of endometrial, ovarian, or primary peritoneal cancer among the women who had undergone prophylactic surgery.
Endometrial cancer was diagnosed in 33% of women in the control group, yielding 100% prevented fraction of 100 percent.
The research team noted that ovarian cancer was diagnosed in 5% of women in the control group, also yielding 100% prevented fraction.
Dr Lu's team concluded, “The findings suggest that prophylactic hysterectomy with bilateral salpingo-oophorectomy is an effective strategy for preventing endometrial and ovarian cancer in women with the Lynch syndrome.”